Surgery & Anesthesia Consent Form

CONSENT OF RISK

I, the undersigned owner or agent of the pet identified above, authorize the staff of Watauga Veterinary Hospital, P.A. to perform the above procedure(s). I understand that some risks and complications always exist with anesthesia and/ or surgery and that I have already discussed any concerns I have about those risks with the attending veterinarian.

A complete physical exam will be performed on your pet prior to the surgical procedure if it has been longer than 30 days since the last exam. However, this may not identify all systemic or metabolic problems. For this reason, your pet will have a pre-anesthetic blood panel to evaluate major organ functions prior to anesthesia if not performed within the last 60 days. I understand that my pet must be up to date on all required vaccinations and free of fleas otherwise necessary vaccines/flea treatments will be administered at an additional cost.

I understand that the attending veterinarian will make every effort to contact me regarding treatment in the case of unforeseen emergencies. If unable to contact me, the staff may or may not have my permission to proceed with life sustaining procedures.

CONSENT OF RESPONSIBILITY

While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved.

I also assume full responsibility for any additional expenses incurred after the surgical procedure is performed, such as follow up radiographs, re-check physical exams and additional surgery due to post-op complications. These are more likely to occur when there is failure to comply with the aftercare instructions.

If my pet should injure itself in an escape attempt, refuse food, soil itself, become ill or die while in the hospital, I will not hold Watauga Veterinary Hospital, PA responsible or liable in any manner whatsoever or any circumstances.

Should the circumstances arise that my pet remains unclaimed after the noted pick up date then I understand my pet will be considered abandoned and this situation will be handled according to the Veterinary Practice Act.

I understand that all of the costs of the stated services (anesthesia, surgery, procedures, boarding, treatments, etc) are required to be paid in full at the time of discharge of my pet.

I have read and fully understand the terms and conditions set forth above.