Drop Off/Dental/Surgery/Anesthesia Consent Form
Language
  • English (US)
  • Español
  • DROP OFF - GENERAL CONSENT

    Section 1. Exam, Bath / Section 2. Dental/Surgery/Anesthesia / Section 3. Acknowledgement
  • Other / Pet Parent Emergency Contact

  • Section 1 (SKIP - If  you are here for a Surgery)

     

    Examinations/Baths

     

    PLEASE READ

     

    By leaving my pet for a bath and/or examination, I authorize Sunset Animal Hospital and its staff to handle, restrain, examine, and provide routine care to my pet as deemed necessary.

    I understand that Bathing, grooming, and handling may cause stress or anxiety in some pets and there is a risk of minor injury (such as scratches, irritation, or soreness), especially in pets that are nervous, aggressive, elderly, or have underlying medical conditions.

    Medical findings may be discovered during the examination or bath that require additional diagnostics or treatment.
    I acknowledge that if my pet becomes stressed, aggressive, or unsafe to handle, the bath or service may be stopped for the safety of my pet and the staff.

    I understand that staff may not be on the premises after hours, and I agree to indemnify and hold harmless Sunset Animal Hospital and its agents from liability arising from routine bath, exam, or handling services, except in cases of gross negligence.

    I assume financial responsibility for all services provided and understand that payment is due at the time of pickup.

  • - All pets must be up to date on Rabies.  Other vaccines are required on a case-by-case basis.

    If proof of Rabies is not provided, it will be given at the owner's expense.

  •  

     

    Section 2 (SKIP - Go to Acknowledgement Section if not Surgery)

    DENTAL CLEANING/SURGERIES

    Your pet has been scheduled for a procedure requiring sedation or anesthesia. By signing this form you authorize Sunset Animal Hospital and its agents to administer tranquilizers, anesthetics and/or analgesics that are deemed appropriate for your pet. Please be aware that all drugs have the potential for adverse side effects in any particular animal. The chances of such an occurrence are extremely low. In an effort to ensure your pet’s safety and anticipate any potential problems before they may occur, we offer pre-anesthetic electrocardiogram and blood testing capabilities to detect hidden heart, liver, kidney, or other issues that may increase the risk to your pet. This testing is available for an additional charge. If abnormalities are detected, we will attempt to notify you, and the anesthetic procedure may be delayed or modified.


    Please verify the procedures being performed and indicate your wishes concerning the option of pre-anesthetic testing. If you have questions, please ask us BEFORE signing and submitting this form. I understand that sedation, anesthesia, or surgery involves risks — including bleeding, infection, organ damage, and death — and that no outcome can be guaranteed. I am aware that the staff is not on premises after hours, and I agree to indemnify Sunset Animal Hospital and its agents harmless from and against any legal liability arising from the care provided. 


    By signing this form, I authorize Sunset Animal Hospital and its agents to administer tranquilizers, anesthetics, and/or analgesics that are deemed appropriate for your pet. Please be aware that all drugs have the potential for adverse side effects in any particular animal. The chances of such an occurrence are extremely low. I consent to perioperative pain relief as deemed appropriate.

     

     I assume responsibility for all charges incurred in the care of this animal. I understand that a deposit may be and any additional charges must be paid in full at the time of discharge for any procedure performed at Sunset Animal Hospital.

  • Section 3 - Acknowledgment, Authorization and Waiver

  • Clear
  •  - -
  • Should be Empty: