All pets admitted to the hospital must be up to date on all necessary vaccinations and routine screenings. Any outdated vaccines or routine screenings will be performed today. You should have been advised whether or not fasting was required for your pet and for how long. Your pet will be admitted, weighed, examined, prepped, and then added to inpatient or outpatient procedure schedules. Please note that it is NOT a first-come, first-serve basis. If our doctors have any questions throughout your pet's stay, they will contact you at the numbers left on this form. Once all services are complete, you will be contacted with a pick-up time, and a veterinary technician will go over a summary of instructions for home care.
Signing below indicates you have been informed that your pet requires preventive or therapeutic dental care and hereby consent to the appropriate procedures described to you by staff veterinarians at this facility. These procedures include, but are not limited to, the following:
Dental prophylaxis (routine cleaning and polishing), extractions, oral surgery to close gaps left by extractions, root canal procedures, filling for cavities, dental x-rays, orthodontic work, and antibiotic gel implants. You are also aware that dental procedures for animals require the use of anesthesia to maximize visualization of the gums, teeth, and oral cavity, minimize movement and discomfort and provide the safety of the pet, doctors, and hospital staff.
You understand that there are always some risks with any anesthetic procedures, and any concerns will be expressed to the veterinarian before the procedure is initiated. The risks may include decreased blood pressure, cardiac arrhythmias, apnea, body temperature variations (hyperthermia vs hypothermia), idiosyncratic reactions to a particular drug, prolonged recovery times, and death. Additionally, there may be complications related to the surgery or procedure itself. My signature on this form indicates that any questions have been answered to my satisfaction.
South Wilton Veterinary Group only uses the safest anesthetic protocols, and patients in our care are closely monitored by a nurse-anesthetist as well as monitoring devices including pulse oximetry, ECG tracing, blood pressure, respiratory monitors, and temperature monitors.
Pre-anesthetic blood tests within 30 days before the procedure are required to help ensure the safety of your pet under anesthesia. These blood tests are used to evaluate the functionality of vital organs like the liver and kidneys, which need to be healthy to metabolize the drugs used during surgery.
A pre-anesthetic ECG is also performed to evaluate the health and function of your pet's heart. If any abnormalities are present, the procedure may be altered or delayed until issues are resolved.
Since the most accurate assessment of your pet's dental health can only be achieved while under anesthesia, we may find that teeth need to be extracted during the procedure. We try to preserve teeth whenever possible, but we often need to extract to preserve dental health and relieve pain. If you have any questions or concerns regarding extractions, please indicate so at the bottom of this form.
I understand that an estimate of fees for the above dental care will be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered. I agree to pay a deposit of 50% of the estimated fees at the time of drop-off. I assume financial responsibility for the balance of the services rendered and agree to provide payment with a credit card, cash, Care Credit, or check when my pet is discharged from the hospital.
I, the undersigned owner or agent of the pet owner identified above, certify that I am eighteen years of age or older and authorize the veterinarians at this practice to perform the above procedures.