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Sedation / Treatment Consent Form

MM slash DD slash YYYY
Sex(Required)

Risks and Emergency Measures:

There are natural risks involved with the surgery itself, and the use of anesthetics and other drugs. Injury and death can result from the surgery, any related procedures, and from complications following surgery even in health non-symptomatic animals. The following conditions increase the possibility of complications or death before, during, or after surgery:

  • Animals in advanced stages of pregnancy
  • Animals in heat
  • Animals of advanced age
  • Animals suffering from worms, leukemia, or other diseases or injury.

CPR

In the event that the pet listed above should experience cardiac or respiratory arrest while being hospitalized today, do you give consent for resuscitative efforts to be initiated until you can be contacted further and notified of your pet's status.

By consenting to this service, you are also acknowledging that certain fees will apply. If you are not able to be contacted immediately, resuscitation efforts will be continued to be performed at the doctor’s discretion.

Election(Required)