Randolph Animal Hospital
Surgical Consent Form
ALL PETS ADMITTED MUST BE CURRENT ON THEIR VACCINATIONS AND MUST BE FREE OF EXTERNAL AND INTERNAL PARASITES. ANY PET FOUND TO HAVE FLEAS, TICKS, OR INTESTINAL WORMS WILL BE TREATED AT THE OWNER’S EXPENSE.
Dogs- Current on Rabies, DHLPP, Bordatella, and intestinal parasite check within one year Cats- Current on Rabies and FVRCP
Surgical Procedures (Please check those boxes that apply)
LABORATORY TESTS: Preanesthetic bloodwork is a safety screening to assure proper organ function, clotting ability, detect anemia or infection, and a baseline for future reference. IV fluid therapy maintains blood pressure, replaces blood loss, speeds recovery, and can be used to administer emergency life- saving drugs. If you have any questions, please ask to speak to a veterinarian.
Comprehensive pre-anesthetic blood work (cost is $64.12) and an IV Catheter (cost is $58.92)is required for any pet 6 years of age or older undergoing a surgical procedure.
A minimum pre-surgical panel is required for all pets under six years of age undergoing a surgical procedure. (Cost is $21.38) THIS PANEL DOES NOT CHECK ORGAN FUNCTON. IV fluids are given at the veterinarian’s discretion.
If your pet is less than 6 years old, a comprehensive pre-surgical safety panel is highly recommended.
I understand that during the performance of this procedure, unforeseen conditions may be revealed that require an extension or variation of the procedure(s) listed above. I expect Randolph Animal Hospital to use reasonable care and judgment in performing the procedure. The nature of the procedure and risks involved has been explained to me and I realize results cannot be guaranteed. I am also aware that unforeseen events resulting from the procedure(s) will not relieve me from any obligation to all reasonable costs incurred regarding the pet’s care.