Authorization for Treatment and Pre-Anesthetic Testing Profile Consent Form Logo
  • Authorization for Treatment and Pre-Anesthetic Testing Profile Consent Form

  • Pre-Anesthetic/Pre-Sedation Blood Testing

  • Your pet is scheduled for a procedure requiring the use of anesthetic and/or sedation. We, like you, consider your pet's well-being to be our highest priority. Prior to anesthesia or sedation, we will perform a full physical examination to ensure there are no pre-existing medical conditions that may potentially cause complications.

    Advances in anesthesia and anesthetic monitoring techniques have made routine procedures very safe, with low rates of complications. However, you need to understand that occasional problems can occur due to the possibility of pre-existing conditions that are not evident during routine histories and physical examinations. To minimize complications, the veterinarians and staff at this veterinary practice strongly recommend a pre-anesthetic/pre-sedation blood test. Although the blood test does not totally eliminate risk, it greatly reduces the possibility of complications by identifying conditions that may require further treatment. It also allows the veterinarian to choose the safest medications pre- and post-operatively.

  • Client Authorization

  • I, the undersigned, owner or authorized agent of the admitted patient, hereby authorize Glamorgan Animal Clinic, and whomever they may designate as their assistants, to administer such treatment as necessary, and to perform medical and/or surgical procedures and additional procedures as are diagnostically and/or therapeutically necessary as indicated by findings during medical evaluation.

    I give full and complete authority to perform the following procedure (click on "ADD MORE" to type in any additional procedure(s) to be performed):

  • I hereby certify that I have read and fully understand the above authorization for medical and/or surgical treatment. I also certify that no guarantee or assurance has been made regarding the results that may be obtained. Further, I assume full financial responsibility for all charges generated by such services incurred to the patient, and that all fees must be paid in full at the time the services are performed or upon discharge from the clinic (any exception to this policy must be authorized prior to the performance of any service). In addition, I consent to release of medical information as needed.

  • Authorization of Additional Procedure(s)

  • Authorization of CPR

  • Pre-existing Medical Conditions and Current Medications

  • Info for Procedure Day

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