Anesthesia Consent

Consent Form

Please Note: Any fields with * are required. If you have any questions, please feel free to contact us.

* Indicates required field

Pet's Name *

Breed *

Color *

Male or Female *

Male Female

Spayed / Neutered *

Yes No

Species *

Canine Feline

Age / Date of Birth *

Weight *

I am the owner (or authorized agent of the owner) of the animal described above and have the authority to execute this consent. I understand that some risk always exists with anesthesia, even in apparently healthy animals, including the possibility of death. I have discussed my concerns with the veterinarian. I realize that no guarantee, legal or ethical, can be made to me regarding the outcome of any procedure performed. I hereby authorize the use of anesthetics, as deemed necessary by the veterinarian. I understand that hospital personnel will be employed in treating my pet. I have carefully read and fully understand this consent. The fees associated with these services have been explained to me, and I agree to pay such fees in full at the time my pet is released from the hospital.

Please note and understand that if one of our Bayview pet clients is found to have fleas, we have the right to treat at your expense. This is to prevent the spread of fleas to our other patients.

Owner Name *

First

Last

Best Contact Phone Number *

Alternative Contact Phone Number *

Email *

Please type your signature *

Submit

Anesthesia Consent

Consent Form

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