Surgical Consent Form

Owner Responsibility:
• I understand that home care administered by myself or a designated caretaker may be required to achieve best overall success. It is my responsibility to notify Friendship Animal Hospital before altering the doctor’s recommendations. I understand that changes, supplementation, or alteration of any prescriptions may possibly result in an unfavorable or detrimental side effect with medical complications.
• I agree to make myself available by telephone during the approximate time interval of 9:00am to 1:00pm.
• Home care instructions will be provided at the time of the pet’s discharge.
• I understand that payment for services rendered will be due in full at the time of my pet’s discharge.

Hospital and Procedural Information:
• Anesthesia: Pre-surgical blood tests and physical exam will enable us to assess and minimize the risk of anesthesia to your pet.
• Monitoring: To minimize anesthesia risk, we monitor the heart, blood pressure, respiration rates, temperature, and oxygenation.
• Catheterization: For sterility, hair will be shaved over a vein on the leg so that an intravenous catheter (I.V.) can be placed. Blood pressure may lower during anesthetic procedures and fluid therapy aids in supporting your pet’s internal organ systems. It also allows immediate access to the vascular system in case of an emergency.
• Pain Management may be necessary in most surgical procedures. The doctor will administer pain medications according to your pet’s needs, which can be an additional fee ranging from $20.00 to $50.00.
• Antibiotics are an additional fee ranging from $20.00 to $50.00 and may be prescribed by the doctor for your pet’s needs.
• Pre-Op Blood Work: Blood work is required for any patient going under anesthesia to ensure that kidney and liver function is adequate to process and eliminate anesthesia.

Authorization *

Yes, I agree No, please contact me

YOUR CART

Anesthesia & Surgical Consent Form