Anesthesia/Dentistry Consent Form
As the owner (or the authorized agent of the owner) I authorize Moore Veterinary Hospital to perform any diagnostic, therapeutic, anesthetic, emergency, and surgical procedures as specified by this release, and approve the use of whatever anesthetics you deem advisable for the well-being of the animal’s safety while it is in your care. I have been advised as to the nature of the procedure and the risks involved. I understand that complication, including but not limited to infection, cardiac arrest, and death could result. I acknowledge that no guarantee has been made as to result cure. I understand that you will use reasonable precautions to assure the animal’s safety while it is in your care and absolve you of all liability arising from the performance of procedures requested herein.
I agree to pay in full for services rendered, including those deemed necessary for medical and/or surgical complications or unforseen circumstances. I understand that any estimate that may have been given is an approximation, and that the actual cost may be greater or less. All payments are due at the time of discharge.
Flea control is very important at Moore Veterinary Hospital. Should we discover that your pet has fleas, they will be treated with a dosage of appropriate medication according to their weight. I understand that I am financially responsible for the cost of said treatment. In this manner, we can ensure the transmission of parasites is prevented between animals and we maintain a flea-free hospital environment.
I have read and understand this authorization and consent.
Authorized Procedures: DENTAL/ANESTHESIA
It is important that we be able to reach you while your pet is under anesthesia. Please list the telephone number(s) that we can best reach you between 10:00am and 1:00pm.