Anesthesia and Surgical Consent Form

As the owner or authorized representative of the owner of the pet, I give permission for the following surgery or treatments:

Please select any additional procedures that will be performed

Please select which vaccines requested

Recommended Services

IV fluids- The IV catheter provides quick access to a vein in case of an emergency and assists in maintaining blood pressure. IV fluids may be required by the veterinarian on a case-by-case basis.(Required)

Pre-anesthetic blood panel- We highly recommend a pre-anesthetic screening . A pre-anesthetic screening maximizes the patient's safety and alerts the doctor to the presence of dehydration, anemia, infection, diabetes and/ or kidney or liver disease that could complicate the procedure. This may be required by the veterinarian on a case by-case basis.(Required)

Consent for CPR

Should my pet require CPR, including compression, positive pressure respiration, emergency drugs, and/or any other life-saving interventions, I request that the doctor at this hospital pursue such medical care.(Required)

Authorization and Risk Assessment

Electronic Consent(Required)

MM slash DD slash YYYY

Pick-up Time


This field is for validation purposes and should be left unchanged.