CPR / DNR

CPR / DNR
Client

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Some form of anesthesia and/or sedation is required for all surgical procedures. Precautions are taken for each patient as an individual when it comes to anesthesia. However, life threatening complications such as respiratory and/or cardiac arrest may occur requiring cardiopulmonary resuscitation (CPR). These complications can occur regardless of patient age. I understand even the most successful CPR may not restore him/her to good mental and physical health.

In the unforeseen event my pet suffers cardiac or respiratory arrest that requires CPR, I request that the veterinarians and/or trained staff at Mendon Village Animal Hospital pursue such medical care as indicated below.
Please initial ONE of the directives listed below:
Initial Resuscitate: I authorize emergency treatment if the situation arises (including CPR and other life-saving treatments) and understand this may result in additional charges. I agree to pay for these emergency and life-stabilizing treatments even if they exceed any estimate I may have been provided.
OR
Initial Do Not Resuscitate (DNR): I do NOT authorize emergency treatment if the situation arises (including CPR and other life-saving treatments). I understand that my pet will pass away in the event he/she stops breathing and/or his/her heart stops beating.
Initial* I understand that despite the best efforts of the medical team at Mendon Village Animal Hospital, any emergency treatment, including CPR does not guarantee my pet will have a favorable outcome.
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CPR / DNR

Please initial ONE of the directives listed below:

OR