Surgery and Anesthesia Consent Form

Surgery and Anesthesia Consent Form

Pre-Anesthesic blood profiles:

In an attempt to minimize the risks associated with anesthesia and surgery, we advise that pre-anesthetic tests be performed, even for elective services. This bloodwork provides a thorough evaluation of your pet's organ function, blood cell counts, and clotting factors to ensure they are able to clot blood normally. We highly recommend this for pets 5 years of age and older.

Additional blood tests:

• 4DX snap test (Heartworm, Lyme, Ehrlichia, and Anaplasmosis test): We recommend this test for every dog 6 months of age and older.

• Felv/FIV test (Feline Leukemia and Immunodeficiency Virus Test): We recommend this test for every cat that goes outside, is not vaccinated for leukemia, and/or has had a bite wound within the past 6 months.

Biopsy of growth (if applicable):

We will be sending the sample to a pathologist to interpret what the growth is. It can take up to 2 weeks for us to receive the results.

Bladder stone analysis (if applicable):

We will be sending the sample to a pathologist to interpret the type of bladder stone. It can take up to 2 weeks for us to receive the results.

Additional Services offered:

• HomeAgain Microchip: Your HomeAgain microchip ID number will be permanently registered in the HomeAgain National Pet Recovery Database. The microchip includes the first year of membership for free. Membership provides services such as pet recovery for lost pets, a medical hotline, and lost pet travel assistance.

• Fluoride treatment: Fluoride supports healthy tooth enamel and fights the bacteria that harm teeth and gums.

Vaccines:

Pennsylvania State Law requires that all dogs and cats, 3 months of age and older, must have a current Rabies Vaccine.

Elizabethan Collar (E-collar):

If your pet is admitted to the hospital and has fleas, the staff will give your pet an oral flea treatment called Capstar.

Consent/Authorization for surgery/anesthesia:

• I understand that all reasonable care and precautions will be taken in performance of the procedures. I understand that with any anesthetic procedure, there are risks involved, including death, and I understand these risks.
• I understand the procedures to be performed and the risks involved. I also understand that doctors and staff may initiate life-saving procedures in the event of an emergency.

• I certify that I have read and understand this release, and furthermore, that I assume full financial responsibility for all charges related to the above procedures.