Labwork Consent

1152 Stonecrest Boulevard

Tega Cay, SC 29708

(803) 547-8387

www.baxtervet.com

Labwork Consent Form

Client Name*

Patient Name*

I hereby certify that I am the owner of the above-named animal or am responsible for it and have authority to execute this consent.

It is, in some cases, important that a pet fast for labwork or that the labwork be performed with a certain time after giving medication.

When did your pet eat last?*

Current Medication(s):

When did you give the last dose of each?

Refills Needed:

I do / do not authorize the use of such sedatives/anesthetics as you deem advisable and performance of such surgical or therapeutic procedures as you determine to be indicated. I agree to idemnify and hold Baxter Veterinary Clinic harmless from and against any liability arising out of any of the procedures referred to above.*

I Do Authorize Use of such Sedatives / AnestheticsI Do NOT Authorize Use of such Sedatives / Anesthetics

I do / do not authorize CPR or other life saving procedures in the event of an emergency.*

I Do AuthorizeI Do NOT Authorize

As discussed, I understand and consent to have the services performed today.*

My signature above verifies that I am at least 18 years of age and am financially responsible for this pet. With this signature, I agree to terms and services discussed on this consent form.)

Best contact name and number:

You will be notified by text message when your pet's care is complete.