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Surgery / Anesthesia Consent Form

Pre-Anesthetic & Post-Operative Protocol

It is highly recommended to perform all of full comprehensive bloodwork, including the clotting profile.

The results of these tests give us an overall look at your pet's health and ability to tolerate the anesthetic drugs.

Pre-Surgical Bloodwork —Serum Chemistry/Complete Blood Count - $185

Checks for anemia, infection or pre-existing condition prior to anesthesia & surgery.

Clotting Profile - $45

Checks for bleeding or clotting abnormalities prior to surgery.

Cerenia Injection - $ based on weight

Counteracts nausea and vomiting associated with sedation and reduces risk of aspiration pneumonia. Price is pet specific - based on body weight.

Laser Therapy - $45

For after the procedure. Reduces pain, expedites healing, & reduces inflammation post- operatively.

IV Catheter +/- Fluids

Highly recommended for direct access to your pet’s blood supply in case of an emergency & IV fluids help maintain blood pressure during anesthesia. Price is pet specific - based on body weight.

Certain procedures may not warrant IV catheter & IV fluid administration. By signing approval, you are allowing doctor’s discretion.

Capstar - $9.50

Capstar is given for every pet that is admitted into the clinic.


Every pet gets a 24 hour dose of pain medication prior to surgery; however, some pets will still have pain for a few days following their operation. There will be an additional cost depending on your pet's weight and type of procedure that is performed.


Every pet gets a 24 hour dose of a broad spectrum antibiotic prior to surgery; however, some pets will need additional antibiotics following their operation. There will be an additional cost depending on your pet's weight and type of procedure that is performed.

Liquid antibiotic to give daily for 7 days.
One time antibiotic injection that lasts for 14 days. Recommended for cats that are difficult to pill or give medication.


IF extractions or additional procedures are recommended by your veterinarian, would you like us to:


It is recommended that all growth/tumors be sent to a laboratory for a biopsy by a boarded pathologist. A histopathology report is the ONLY way to definitively determine the tumor origin and if it is benign or cancerous.

Costs will be discussed prior to submission.

Please confirm location & number of growths/tumors that are being removed with one of our staff members prior to drop-off. 


In the rare event that your pet should experience cardiac or respiratory arrest while being hospitalized today, do you give consent for resuscitative efforts to be initiated until you can be contacted further and notified of the status?

By consenting to this service, you are also acknowledging that certain fees will apply. If you are not able to be contacted immediately, resuscitation efforts will be continued to be performed at the doctor’s discretion. Please select your choice below.

I am the owner or the authorized agent for the owner of the animal described above, and I have the authority to execute this consent. My signature below certifies that I am over eighteen years of age.

I have been informed that there are certain risks and complications associated with sedation, anesthesia, and/or any operation/procedure and that the risks/complications have been explained to me. I further understand that during the course of the operations or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures deemed necessary by the veterinarian. I am encouraged to discuss any concerns I have about these risks with the attending veterinarian before the procedure is initiated.

I authorize the use of appropriate anesthesia and pain relief medication as needed before, during or after the procedure. I have been informed that there are risks associated with the use of any medication.

The nature of these operations or procedures has been explained to me and I understand what will be done. I am aware that the practice of veterinary medicine is not an exact science and, thus, there are no guarantees for successful treatment. I have been encouraged and given the opportunity to discuss any questions I may have regarding my pet's medical care and my questions have been answered to my satisfaction. I accept that my financial obligations remain regardless of the outcome.

I have read and understand this authorization and hereby accept and agree to the terms of the consent for treatment.

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