Surgery
Consent Form

Thank you for giving Eastside Veterinary Hospital the opportunity to care for your pets. Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

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Surgery Consent Form Completion for Optimal Pet Care

We are glad to have the opportunity to care for your pet. To ensure your pet gets the best care we can offer, please fill out the following form completely.

Owner's Name *

First

Last

Email *

Surgery

IMPORTANT - Any flat nosed breeds will require special anesthesia drugs at an additional cost

Pre-Anesthesia Profile

For the safety of your pet, We highly recommend a pre-anesthesia blood profile. This test will help us determine the status of the liver and kidneys to see if they are healthy.

Pre-Anesthesia Profile

For Pets Under 7 Years
For Pets Over 7 Years (required)
Preventative Care Screen
Decline Lab Work

IV Catheter for Anesthesia

We recommend IV catheter to provide an access to the heart for emergency drugs or IV fluids if needed.

IV Catheter for Anesthesia

IV Catheter
Decline IV Catheter

Pain Management (included in spay and neuters)

Yes
Decline

Additional Procedures Must be Current on All Vaccinations

Current on Heartworm Prevention?

Heartworm Test ?

Consent *

I understand that during the performance of this procedure, unforeseen conditions might be revealed that necessitate an extension or variance in the procedure(s) set forth. I expect to use reasonable care and judgment in performing the procedures(s). Possible complications of anesthesia include, but are not limited to: post anesthetic sedation, seizures, and death. The nature of the procedure and risks involved has been explained to me and I realize results cannot be guaranteed. I understand that veterinary care during the nighttime hours and/or weekends is provided at the discretion of the attending veterinarian. Continuous presence of personnel is not provided during these hours. If continuous care is deemed appropriate for my pet, EVH may recommend transfer to an overnight or 24 hour facility. Transmission of contagious disease is a possibility in any kennel. Contagion is uncommon and the diseases are usually mild. Despite our best efforts to avoid transmission, boarding pets can acquire contagious diseases. Owners must be aware of this risk and assume responsibility for any additional medical expenses in treating a pet while boarding and after it has returned home. I am also aware that unforeseen events resulting from the procedure(s) will not relieve me from any obligation to all costs incurred regarding the animal. I give permission for my pet(s) to be photographed, or their images to be posted on Eastside Veterinary Hospital's website or social media pages. All pets must be free of external parasites (ex. Ticks & fleas) or they will be treated at owner’s expense

Contact Phone *

Signature *

Clear Signature

Date *

Surgery
Consent Form

Surgery Consent Form Completion for Optimal Pet Care

Pre-Anesthesia Profile

IV Catheter for Anesthesia

Pain Management (included in spay and neuters)

Additional Procedures Must be Current on All Vaccinations

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Questions?

Location

Contact Information

Hours

SurgeryConsent Form

Surgery Consent Form Completion for Optimal Pet Care

Pre-Anesthesia Profile

IV Catheter for Anesthesia

Pain Management (included in spay and neuters)

Additional Procedures Must be Current on All Vaccinations

Surgery
Consent Form