Pet Information

Pet's Name *

Age *

Sex *

Male or Female?

Spayed or Neutered? *

Contact Information

Owner's Name *

First

Last

Email *

Emergency your pet

Best Phone Number *

Emergency Phone

if different

I, the undersigned, certify that I am the owner/agent of the animal described above. I give Vetfield Animal Hospital & Mobile Vet permission to give/use anesthesia on my pet. *

While there are risks associated with general anesthesia, be assured that VetField Animal Hospital & Mobile Vet will take every precaution to minimize risk by always performing the following:

✓ Physical exam prior to anesthesia

✓ Multi-parameter monitoring (blood pressure, EKG, CO2, heart/respiratory/temp)

✓ Intravenous (IV) catheter and fluid therapy

✓ Preoperative and postoperative pain control injections

✓ Endotracheal intubation and oxygen therapy

✓ Injectable and inhalant (Isoflurane or Sevoflurane gas) anesthetics based on your pet's age and specific medical needs.

I understand the following additional procedures are optional, but highly recommended *

Pre-operative Bloodwork (recommended on all pets, required on animals > 4 yrs. old) *

Oral pain medications and antibiotics to go home *

Heartworm test for dogs; FeLV/FIV test for cats *

Post-Op Laser Therapy for pain and inflammation relief *

It is important that we have a phone number where you can be reached if consultation is necessary while your pet is under anesthesia

Phone *

If you can't be reached, do you want the veterinarian to proceed at his/her own discretion? *

Does your pet have any history of SEIZURES? *

I hereby authorize VetField Animal Hospital & Mobile Vet to perform such diagnostic, therapeutic and surgical procedures as described above. The nature of such services has been described to me to my satisfaction. I realize that there are risks involved with any anesthetic or surgical procedure and that no guarantee or warranty can be made regarding the results or cure. I also authorize the hospital staff, in an emergency, to follow through with such procedures as are necessary for the well-being of my pet on a continuing basis until further communication with me. I have been given an estimate and understand that it is an approximation of planned procedures, and the final bill may be more or less than this amount. I understand that I assume financial responsibility for a rendered.

Owner's Signature *

Clear Signature

Date *

VetField Animal Hospital

Sedation Consent Form

Pet Information

Contact Information

It is important that we have a phone number where you can be reached if consultation is necessary while your pet is under anesthesia

Expert Veterinary Care in Sunrise, FL

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