Anesthesia Consent Form

Please complete the form below before your pet’s procedure.

Pet Information

Contact Information

This person has the authority to consent to medical decisions regarding your pet's surgical care in the event we cannot reach you.

Surgical Procedures

Today's Scheduled Surgery

(example: neuter, dental cleaning, etc.)

Additional Services Desired While Patient Is Sedated

Please Note: This is required for patients 7 years and older.

Authorization

Clear Signature