Online Forms

Anesthesia/Surgery Consent Form

Save time during your pet’s next surgery appointment! Complete your required forms online from any device at any time before your visit.

Anesthesia/Surgery Consent Form

Please fill out this form as completely and accurately as possible so we can get to know your pet(s) before your visit.

Pet Information

Pet's Medical History

Surgery and/or Anesthetic Procedure

The most common complications include:

Swelling around or beneath the incision line.

Additional risk factors include: Pets that are obese incur higher risks and higher fees associated with their procedure. Although extremely rare, the most serious complications include: Anesthetic death, Excessive bleeding, Infection afterwards.

If there is an underlying problem that we are unaware of, the problem could worsen with the stress of anesthesia or the possibility of compromising any organs that may be having problems that we are unaware of. Below are some options to add to your pet's procedure to decrease risk and make procedures as safe as possible


The very best and most safe way to do it is to choose the package, which includes several of these options and gives you a discount while making the procedure as safe as possible.

Anesthetic Safety Screening (pre-anesthetic blood chemistry and CBC)

To check proper organ functions, oxygen carrying ability of blood, ability to fight infection, platelets for proper clotting, and to establish a baseline for future reference.

REQUIRED for pets over 7 years of age.

IV Catheter and Fluid Therapy (Included)

Pain Management

More comfortable and faster recovery. Options:
Injection given prior to surgery discharge (included)

Fluoride Treatment

A cone may seem shameful, but it helps avoid the chance of infection after surgery, usually caused by your pet licking on their incision site.

Safety and Comfort Package Discount ($25)



I, the undersigned owner or agent of the owner of the pet identified above, certify that I am eighteen years of age or over and authorize the veterinarian(s) at this practice to perform the above procedure(s). I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:

  • The reasonable medical and/or surgical treatment options for my pet
  • Sufficient details of the procedures to understand what will be performed
  • How fully my pet will recover and how long it will take
  • The most common and serious complications
  • The length and type of follow-up care and home restraint required
  • The estimate of the fees for all services
    Clear Signature