You are here: Home / About Us / Hospital Forms / Anesthesia Consent

Anesthesia Consent

You may either download the form to fill out and bring in with you by clicking here or fill out the form below.

  • Advances in anesthesia and surgery have made routine procedures very safe, with a low rate of complications. Nevertheless, occasional problems can arise due to pre-existing conditions not evident during pre-anesthetic physical examinations. To minimize the risk of complications and to establish a baseline of medical data, we recommend blood tests prior to anesthesia and surgery. The type of test(s) recommended will depend on the physical condition of your pet and the nature of the surgery. General recommendations are listed below, and a technician will answer any questions you may have when your pet is checked in for surgery.

  • Please select the tests authorized:

    Please enter 1 in the quantity of for the authorized tests.
  • Price: $35.00 Quantity:
    Recommended for dogs over the age of 5 months and not currently on heartworm prevention.
  • Price: $50.00 Quantity:
    Recommended for cats that go outdoors or cats with unknown backgrounds.(includes specimen collection fee)
  • Price: $45.00 Quantity:
    Recommended for healthy, young (less than 8 years old) pets.(includes specimen collection fee)
  • Price: $134.00 Quantity:
    Recommended for senior pets (8 years old and over), and / or systemic disease present and / or extensive surgery. (includes specimen collection fee)
  • Price: $60.00 Quantity:
    To measure kidney functions. (includes specimen collection fee)

  • Other optional procedures

    Please enter 1 in the quantity of for the authorized optional procedures.
  • Price: $45.00 Quantity:
  • Price: $25.00 Quantity:
  • Price: $12.00 Quantity:
  • I authorize the use of diagnostic procedures and anesthetic agents as deemed necessary for the safety of my pet. I understand that even after performing these tests there is still a slight risk of anesthetic or surgical complications or even death that would be unforeseeable at this time. I acknowledge the procedures have been explained to me and I understand the risks involved with anesthesia and surgery.
    By checking this "Confirmed" box you acknowledge that you have read and understand the authorization and consent and that you have filled out this form completely and accurately.