• Surgical & Nonsurgical Procedure Authorization

  • I, the undersigned ,attest that I am the lawful owner of the pet name    and I affirm that said pet has not drank water or eaten any food or other substances past 10:00pm the night before its scheduled procedure.

    I further affirm that my dog is current on the following vaccinations: Rabies, DHPP and      Bordetella, and/or that my cat is current on the following vaccinations: Rabies, FVRCP, FELV, based Upon the requirements set forth by Stanton Pet Hospital and that said vaccines must be administered to my pet (5) days prior to the scheduled Procedure. Vaccines will be given at the times of spay or neuter without current vaccine history. The owner will take responsibility for this.

    Prior to hospitalization I understand that I must present proof that my cat has been previously tested (and the results are negative) for Feline Leukemia Virus (“FeLV”) and Feline Immunodeficiency Virus (“FIV”).      

    We will call you for pick up time unless otherwise arranged with the front desk. There is no overnight staff on Premises.

    I understand that there are certain inherent risks involved with undergoing any surgical procedure, administration of anesthesia and/or medications, recovery from surgery, and/or staff of Stanton Pet Hospital has explained to me and advised me of the dangers and risks involved in such procedures as well as the risk and possible consequences as a result of refusing any recommended treatment and/or diagnostic testing. As such, I attest that I full understand same and agree to accept and/or refuse the following procedures for my pet

  • Treatment

  • CASTRATION (“Neuter”) (Includes Anesthesia, Surgery, Antibiotic Injection, Hazardous Material Disposal fee, 7-14 day recheck required for suture removal at no cost.)
       *

  • OVARIOHYSTERECTOMY (“Spay”) (Includes Anesthesia, surgery, Antibiotic Injection, Hazardous Material Disposal fee, 7 and 14 day recheck with suture removal. (In heat additional charge $45/dogs, $25/cats).    *

  • NAIL TRIM (Additional Cost)    *
    PAIN INJECTION (Additional Cost)      *   
    IV CATHETER & FLUIDS (Additional Cost)      *   
    PRE-OPERATIVE BLOOD WORK (Additional cost)      *   

  • TEETH CLEANING (Includes Anesthesia, Hospitalization, Scaling, Polishing, Antibiotic Injection, Hazardous Materials Disposal Fee, 7 and 14 day recheck is required at no cost.)
       *
    EXTRACTIONS (Additional cost)      *   
    SEDATION/ANESTHESIA    *   
    CAPSTAR (Additional Charge if Fleas are seen). Exam      

  • I hereby hold Stanton Pet Hospital, its employees, independent contractors, volunteers, affiliates, associates, Agents and representatives free and harmless from any and all liability derived from any claim, legal or otherwise, involving aunty car, testing, or treatment, rendered to the above- named pet, or as a result of my decision to decline any care, testing, or treatment of said pet.

    I hereby authorize and direct the veterinarian(s) at Stanton Pet Hospital to perform the procedure(s) as indicated above, and I authorize any additional diagnostic testing or treatment as deemed necessary in the event of an emergency, complications, or other unforeseen medical situation which would necessitate additional treatment in order to sustain my pet’s health and welfare, whether during, prior to, or post-surgery. As such, I understand that I am responsible for any additional costs incurred under the aforementioned circumstances and agree to pay such fees in cash (U.S. Currency) prior to the release of my pet and/or immediately upon services rendered, whichever may apply.

    I acknowledge that I have read, understand, and agree to this Release, I am not under duress, I am signing this Release of my own free will, I have received a copy of this document, and this Release is a legal and binding contract. I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct.

    Executed this   *   day of   *   , 20   *   at Stanton, California.     

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  • Anesthetic Risk and Benefit

  • If we could talk to animals, one of their wishes might be health care without the need for anesthesia.

    We would picture an English bulldog reclining in the dentistry chair, complaining about his weight loss plan while their teeth are being tended to. Imagine the Tom cat getting stitched under local anesthesia after his latest fight exclaiming “You should have seen the other guy, doc!”

    Although anesthesia is a daily event in veterinary practice, there are many misconceptions about its use. We would like to help you understand the procedure and risk so you can make informed decisions about your pets’ care.

    Anesthesia is the use of drugs to bring an animal into a state of unconsciousness, so they are able to tolerate the medical procedure .Although there are different types, the most commonly used protocols combine injectable drugs and inhalant gas.

    Before undergoing anesthesia, it’s important that the animal be in a calm state of mind; not stressed by fear or aggression. Combinations of drugs are used to calm your pet and decrease overall requirements of individual drugs, and inhalant gas.

    The sedation extends beyond the influence of the gas, easing your pet into and out of the major part of the procedure. One advantage of long lasting sedation is that it gets the recovery off to a good start, and it may keep the pet from re-injuring itself upon awakening. This is why your pet may still be sleepy when arriving home.

    The major part of anesthesia is accomplished by letting the animal inhale anesthetic gas and oxygen through an endotracheal tube placed into the trachea or windpipe. The effects of the gas extended beyond the time of treatment/surgery.

    The risk of anesthesia, while rare, may range from minor allergic reactions, undetectable and temporary injury to certain organ systems, to death.

    While the risk of anesthesia is certainly minimal in healthy patients, there are several situations where adverse reactions can occur. Age is not a disease, but geriatric patients pose slightly higher risk because of potential organ dysfunction. The geriatric pet is actually the most common type of patient we anesthetize, because of their increased need for medical care. Anesthetic agents cause unconsciousness animals which are compensation for an undiagnosed condition may be unable to compensate for their disease while under anesthesia. For example, a cat with heart disease which appears healthy on a physical exam, because it is coping by making its heart work harder may be unable to do it under anesthesia. In addition, some animals, like people, may be allergic to certain anesthetic medications and may suffer an allergic reaction ranging from swelling to anaphylactic shock. These cases are rare (the overall risk of anesthesia death in dogs and cars is 0.1% in 1000) but is something to consider, when looking into the risks and benefits for Anesthesia.

    Diagnostic tests such as blood can help us make decisions as to the safest anesthesia for your older pet. While these precautions add to the cost of the anesthesia for older animals, they allow the life-extending benefits of such procedures as dentistry to be given to all your pets.

    Your pet’s vital parameters are monitored during anesthesia by a certified technician or veterinarian. We use many of the same parameters used by a human anesthesiologist such as carbon dioxide concentration.

    No discussion of anesthesia can be complete without a few words on your pet’s owner’s responsibilities

    – Follow your veterinarian’s instructions on preparing your pet from surgery. If there is a no-food instruction, make sure you deliver a pet with an empty stomach. Following this one piece of advice is one of the easiest and most basic ways to reduce risk.

    – Be prepared to provide special home care for your pet after surgery. It is common practice for veterinarians to release animals before the pre-anesthetic sedation wears off. Such animals must be kept safe from extremely hot or cold environments. If you do not feel comfortable caring for a sedated pet, arrange for your veterinarian to extend care.

    – Don’t hesitate to ask questions. Make sure you understand what the procedures are and what to expect. For example, it is common for pets to cough after anesthesia, since the endotracheal tube used to deliver the gas may cause some irritation. If the cough does not clear up in a couple of days, please call our office at : (714) 828-5891 or (714) 820-6051.

  • Your pet may vomit after surgery. This can be due to water, food in the stomach, or nausea, from anesthesia. This injection called CERENIA will help prevent nausea, although it is an extra charge of $54.17. When would you prefer your pet to receive the injection . . .

    Before Surgery   *  After Surgery*   Decline Injection   *   

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  • E-Collar      Accept      Decline     

  • Pregnancy OR in heat fee  *   
    Euthanasia fee for later-term Pregnancy for fetuses   *   

  • Emergency Veterinary Care and Authorization

  • While your pet is in our care, we ask that you elect a CPR code in the event of an emergency where cardiopulmonary resuscitation is required.

    If you are not on the premises at the time of such an emergency, we will use this code as your initial instructions on which to base our care of your pet until you can be reached.

    Please select which CPR code below AND initial next to the code of your choice.

    *   Basic CPR (additional fee $400+)
    *   No Resuscitation Efforts (DNR)

    I understand that I am solely responsible for the payment of all veterinary services rendered.

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