| Client Name |
Animal's Name |
Date |
Procedure(s) |
The doctors at Silver Bluff Animal Hospital aim to provide the safest and best care for your pet. In accordance with the surgical standards of care provided by the American Veterinary Medical Association, all of our surgical procedures include Pre Operative Bloodwork, Pre and Post Operative Pain Medications, and Intra Operative Fluid Therapy. This inclusive structure has allowed us to offer the best in surgical care in the most economical way.
I, the undersigned owner or agent of the owner of the pet identified above, authorize the Veterinarian(s) at Silver Bluff Animal Hospital to perform the above procedure(s). I understand that some risks always exist with anesthesia and/or surgery and that I have been encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:
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. Should unexpected life-saving emergency care be required and the hospital staff is unable to reach me, the staff has _______ does not have _______ (check one) my permission to provide such treatment and I agree to pay for such services.
I understand that during the performance of medical, surgical, or anesthetic procedures, unforeseen conditions may be revealed that necessitate more extensive, costly, or different procedures than originally planned. If the staff at Silver Bluff Animal Hospital are unable to reach me, I hereby consent to and authorize the performance of such procedures as are necessary and desirable in the professional judgment of the attending veterinarian.
| Signature of Owner |
Patient Name |
Date |
Emergency Phone# |
OraVet (Dental Only)___________ initial
__ Initial Sealant and Take Home Kit
* If applied weekly, this sealant will help reduce the amount of tarter build up and the frequency of dental procedures needed.
|