Anesthesia Consent Form

I, the undersigned owner or agent of the pet identified above, authorize the staff of Pacific Grove Animal Hospital to perform the above procedure(s).

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 a failure to comply with the aftercare instructions. A complete physical exam will be performed on your pet prior to the procedure(s). However, this may not identify all systemic or metabolic problems. For this reason, we require a pre-anesthetic blood panel to evaluate major organ functions prior to anesthesia. I fully understand that the staff makes every effort to remain within the estimate given. However, this is an estimate only, final charges may vary by 20%-25% above or below the estimate. I agree to meet the costs of all treatment at the time of discharge. I understand the risks and complications of these procedures, which have been explained to me by the staff of Pacific Grove Animal Hospital. These risks include, but are not limited to infection, bleeding, suture dehiscence, and poor surgical outcomes.

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

All accounts are payable at the time of consultation unless a prior arrangement has been made.