Animal Care Clinic - Dental Procedures

1
Owner Name
First Name
Last Name
2
Email* This field is required.
example@example.com
3
COHAT (Comprehensive Oral Health and Treatment)
CONSENT AND TREATMENT OPTIONS

Unfortunately, many pets have dental disease that is not evident on a initial exam. X-rays are required to make a therapy decision. Periodontal disease is below the gum line. That is where pain and infection occur. The amount of tarter on the teeth does not actually correlate with the disease below the gum line. Upon sedating and evaluating your pets dental health more throughly, there is always a possibility of finding dental disease such as broken or decaying teeth, infected pockets, abscesses or loose teeth that may require additional treatment.

Our COHAT procedure requires general anesthesia in preparation of a complete head to tail exam, survey ECG and use electronic monitor of heart, respiration, and oxygen levels.COHAT includes:

- Anesthesia
- Photo Charting
- Full mouth digital X-rays
- Next a treatment plan is made if periodontal therapy extractions are necessary. Finally the teeth are cleaned with an ultrasonic scaler and polished.
- In the event that any dental disease is found, and additional treatment is recommended, we want to be sure we know how to proceed so that there are no misunderstandings. Please initial your preference next to one of the following options:
4
IN ORDER FOR US TO COMPLETE OUR TREATMENT PLAN WE NEED YOU TO CHOOSE ONE OF THE OPTIONS BELOW
1.  If diseased teeth or gums are found, I would like my veterinarian to proceed with any and all necessary treatments to best remedy the problem. Teeth may be extracted or repaired at my veterinarians discretion regardless of cost, and I do NOT need to be contacted first, I also understand that depending on the nature of the disease, some procedures can exceed $1,000.

2. I would like the veterinarian to repair any problems found without contacting me, but only if my total bill/invoice today does not exceed $       (please fill in amount). If the anticipated work would exceed the amount I indicated above, do not proceed without contacting me first. I understand you all make ONE attempt to contact me at the number provided below, and that the pet will still be anesthetized when you call. If I do not answer your call, my pet will be recovered from anesthesia without the needed treatment being performed, and that will result in future procedures at added cost to me. I understand that unresolved dental problems can affect my pets quality of life in a negative way.

  3. Do not perform any surgical procedures, advance dental treatment, or extractions without contacting me first. I understand you all make ONE attempt to contact me at the number provided below, and that the pet will still be anesthetized when you call. If I do not answer your call, my pet will be recovered from anesthesia without the needed treatment being performed, and that will result in future procedures at added cost to me. I understand that unresolved dental problems can affect my pets quality of life in a negative way.
5
Signature of Owner* This field is required.
Clear
6
Phone Number
Area Code
Phone Number
Should be Empty: