I understand that some risks always exist with anesthesia and/or surgery, and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian(s) before the procedures are initiated. I understand that some risks always exist with anesthesia and/or surgery. Ormond Beach Veterinary Clinic 226 Vining Court Ormond Beach , FL 32176 (386) 677-0507 Anesthesia/Surgery Consent Form Client ID: Patient ID: Client Name: Name: Address: Species: Breed: Sex: Telephone: Color: Markings: Procedure: Birth Date: If owner shows proof of current veterinary purchased flea and tick product and live fleas are found on patient within 24 hours of leaving Healing Paws Veterinary Care and is reported within 72 hours of going home, a free dose of 30 day veterinary flea and tick preventative will be made available to client. I understand there are risks associated with any anesthesia or surgery and that it may be necessary to provide additional medical treatments which are … ©2021 Gladstone Veterinary Clinic | Powered by WhiskerCloud. We look forward to seeing you! Life-saving measures (i.e. I have discussed my concerns with the veterinarian. GET STARTED. Policy and Practice Considerations . My signature on this consent form indicates that any questions have been answered to my satisfaction. Our greatest concern is the well-being of your pet. An IV catheter placement is REQUIRED for all anesthetized/surgical patients regardless of age. We appreciate your patience and willingness to abide by this new format of veterinary healthcare. ... South Lafourche Veterinary Clinic, formerly Dr. Perry’s Clinic, offers high-quality medicine with a down-home country atmosphere. I hereby certify that I am the owner of the above named animal or I am responsible for the above named animal and have the authority to execute this consent. Provided by Covetrus | Powered by LifeLearn WebDVM Please review the consent and do not hesitate to inform us of any questions or concerns you may have. Please note - on Saturdays we only do tech appointments, vaccinations, nail trims, boarding, and purchase medication and food. We Treat Your Pet as Our Own! Our Mission. I understand some risks always exist with anesthesia and/or surgery, and I am encourage to dicuss any concerns I have about those risks with my veterinarian before the procedure(s) are initiated. Anesthesia Consent Form. The nature and risks of this procedure have been explained to me. If you do not have an estimate and would like one please ask and it … Primary Contact Number(*) Certified Veterinary Technicians – our CVTs are specially educated and trained to provide the best possible care; for your pet’s best health and safety, only CVTs or DVMs monitor anesthesia in our practice ; Inhalant Anesthesia – allows your pet to sleep and wake up faster, smoother, and safer Happy Valley Veterinary Hospital strives to provide excellent client service in a state-of-the-art facility where your pet is a member of our family and not just another dollar. Anesthesia inherently carries some risk. Anesthesia Consent Form. If not download directly. However, disorders of the liver, kidneys or blood, are not detected unless blood testing is done. Shackleford Road Veterinary Clinic will place an I.V. Kewaskum Veterinary Clinic 1040 Fond du Lac Avenue Kewaskum, WI 53040-9583 Anesthesia/Surgery Consent Form For: Client Name Species: Breed: Address: Sex: Color: Telephone: Markings: Birthdate: Your pet will be undergoing general anesthesia plus a surgical procedure today. Therefore, I hereby consent to and authorize the performance of such procedure(s) of operation(s) as are necessary in the exercise of the veterinarian’s professional judgement. The most serious complications may include death. Please complete this form before your visit. * I have read, understand, and authorize. Labahn Veterinary Hospital Dental & Anesthesia Consent From 4100 Kelley Highway, Fort Smith, AR 72904 479-782-1234 Please Read Carefully and Complete the Entire Form I certify that I am over the age of 18 and have permission to act as the representative. This helps to minimize the risk of general anesthesia and to provide us direct IV access in the case of an emergency. cardiopulmonary resuscitation)? This placement allows the veterinary staff to administer fluids to maintain hydration and blood pressure. Click Here >> Online Forms. Sedation/Pre-Anesthetic Consent Form. Costs of these services can be $500 and are NOT reflected in this estimate. I understand that some risk always exists with anesthesia, even in apparently healthy animals, including the possibility of death. We are practicing curbside appointments as we try to limit the spread of this coronavirus. Consent form for anaesthesia and surgical procedures. We have had the honor of providing the highest level of veterinary care to the community and Advanced Veterinary Medical Center is committed to providing excellent care for you and your pet family for many years to come. In the case that your pet were to suffer cardiac and/or pulmonary arrest (heart or breathing stops), do you authorize us to provide Please complete this form before your next visit. Informed Consent for Anesthesia Care . 800 East Capital Ave. Milpitas, CA 95035 408-956-8061. Surgery/Anesthesia Consent Your pet is being admitted to the hospital for completion of services listed on the treatment plan you received from our nursing staff in addition to any services you authorize during the course of their stay. GET STARTED. Puppy & Kitten Care; Senior Pet Care; Spay & Neuter; Vaccinations; Grooming; After Hours Emergency; Client Information. On your pet’s surgery day, we require you to review and sign a Surgery/Anesthesia Consent Form in which you acknowledge understanding of this surgical information packet. However, in the event that your cat experiences an anesthetic emergency and or cardiac/respiratory arrest, our staff needs to know your wishes so we are able to act immediately. You have the right and obligation to … All pets … Second, our doctors and technician will use a computerized monitor that records heart rate, pulse rate, oxygen levels, respiration rate, ECG; temperature. Your pet will be undergoing general anesthesia plus a surgical procedure today. We Treat Your Pet as Our Own! Improving the health of your pet improves the overall health and happiness of the whole family. So that we may expedite your experience, please fill out the surgery and anesthesia consent form below prior to your visit. I accept that veterinary medicine is an inexact science and that no guarantee of successful treatment has been made. After surgery your pet is monitored in a recovery unit with warm blankets. I accept that veterinary medicine is an inexact science and that no guarantee of successful treatment has been made. Although complications are rare, they may include injury, illness, or even death. Anesthesia / Surgical Consent Client Name: Patient Name: Address: Species: , Breed: Sex: Phone Number: Color: Weight: Age: Anesthetic and surgical procedure(s) to be performed: Is your pet on any medications currently, and when was the last dose? Resuscitation Orders: Cats Veterinary does everything possible to limit the chance of an anesthetic emergency. If you choose to allow these procedures for your pet, you will be contacted as soon as possible to be informed of the situation and given the options how to proceed. Your download should start automatically. This also allows us quick access to veins in case of an emergency situation. Compassionate veterinary care 7 days a week in Happy Valley, OR. If you have not yet scheduled an appointment, please contact us at (503) 477-4757.
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