Surgical & Procedural Consent Form

IMPORTANT

If you, the owner, are not present during an exam, treatment, procedure, or surgery it is very important that we have a current phone number in order to reach you at ANY TIME during such treatments, procedures, or surgeries. Please update this information regularly to avoid miscommunication.

We at Petsvet understand that it may be difficult to personally bring your pet to their appointment. Therefore, we would like the names of any spouse, nurse, caregiver, or friend that may initiate treatment on your behalf. Leave these blank if not applicable.

If you are visiting this office for the first time, it is important that we receive all prior, and appropriate medical history for your pet. This information could provide useful information in order to properly treat your animal. It is recommended you contact your previous veterinarian and have this information faxed or emailed to our office.

Our office fax number is: 623-974-4775. Our email is staff@petsvet.net for records only.

Has your pet received the following vaccinations?

If “yes”, you will need to provide record of any prior vaccinations, along with any prior medical history. State law mandates that ALL dogs be vaccinated for the Rabies Virus. Furthermore, this clinic strongly recommends vaccinating against the Distemper Virus and Parvo Virus, as both are highly contagious and extra precaution must be taken to prevent further contamination and infection of other animals.

DOGS

CATS

For Dogs:

It is the owner’s responsibility to maintain control of their pet at all times within Petsvet Animal Hospital. All dogs must remain on a leash AND be kept near the owner at all times. It is also the responsibility of the owner to give a warning to the staff at Petsvet if their pet may be hostile toward people or other animals. If your animal should show aggression toward other animals or the staff, it is the right of the staff of Petsvet Animal Hospital to restrain and apply a muzzle to your animal for personal protection.

For Cats and Smaller Animals:

All cats and smaller animals must be transported within a cage or carrier. If your animal should show aggression toward other animals or the staff, it is the right of the staff of Petsvet Animal Hospital to restrain and apply a muzzle to your animal for personal protection.

The clinic and staff are to use all reasonable precautions against injury, escape, or death of my pet. The clinic and staff will NOT be held liable for any problems that develop provided reasonable care and precautions are followed.

I understand that ANY problem that develops with my pet while I am absent will be treated as seen fit by the veterinarian and staff, and I, the owner, assume full responsibility for the treatment expense involved.

If I neglect to pick up my pet within 5 days of the date below and do not notify the clinic within that time frame, the clinic may assume that my pet is abandoned and are hereby authorized to dispose of my pet as the staff deems best and/or necessary.

I understand the nature of the procedures/surgeries and the risks involved. I realize that the results cannot be guaranteed. I hereby authorize the use of such anesthetics as the veterinarian deems advisable and the performance of such surgical or therapeutic procedures as the veterinarian determines to be indicated.