Today's anesthetic procedure can have common or serious complications which include: vomiting, neurological side effects, respiratory suppression, cardiac suppression, and death. I, the undersigned owner or agent of the owner of the pet identified above, certify that I am eighteen (18) years of age or over and authorize the veterinarian(s) at this practice to perform the above procedure(s). 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 before the procedure(s) is/are initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:
● The reasonable medical and/or surgical treatment options
● Sufficient details of the procedures to understand what will be performed
● How my pet will recover
● Any necessary payment arrangements
● The most common and serious complications
● The length and type of follow-up care and home restraint required
● The estimate of the fees for all services
While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand there's no guarantee or warranty regarding the results that may be achieved. I agree to pay any required deposit of the estimated fees, assume financial responsibility for the remaining fees, and provide payment via cash, credit, debit or check at the time my pet is discharged from the hospital. Furthermore, if there is a need for overnight hospitalization, I have been informed that this establishment is not staffed 24 hours/or overnight and that I am encouraged to transfer my pet to an emergency facility for proper care, treatment, and/or medical observation.
I understand it is a hospital policy to perform pre-anesthetic bloodwork on my pet prior to any sedation or anesthesia today and that if there are any abnormalities which are determined to make an anesthetic procedure unsafe today, I am responsible for paying the cost of the bloodwork to at the time my pet is discharged.