Anesthesia/ Surgery Consent Form

Your pet will be undergoing a procedure today that requires general anesthesia. We use the latest and safest anesthetic protocols available. During anesthesia your pet will be electronically monitored with pulse oximetry, electronic thermometers, and/or an ECG. Body temperature is maintained using a variety of blankets and heating devices. The surgical team will be with your pet the entire procedure. A technician will be monitoring and recording vital sign parameters during both surgery and recovery until your pet is awake. Although general anesthesia dose carry some risk, it is very minor. There are some test and procedures that we do identify any pre-existing problems and to minimize the risk to the patient.

-Includes complete CBC, various chemistry profiles based on the age of your pet. -Although blood profiles cannot identify every problem pet may have, these profiles test functions such as clotting, red and white blood cell counts and internal organ functions. These factors are very important during your pet's anesthesia and recovery, especially as your pet gets older. If a pet is aggressive or fractious and requires excessive restraints or presents a safety problem to staff, we may not be able to collect a pre-anesthetic sample.

-An intravenous catherter and I.V. fluids helps maintain blood pressure, hydration and provides access for drug administration and emergency medication if needed.

I, hereby, consent and authorize Southlake Crossing Animal Clinic, its doctor and staff to perform the above listed procedures. I realize that no guarantee has been made regarding the results of the procedures. I also realize that I am responsible for the payment in full at the time of discharge. Should unforeseen conditions arise, the staff will try to contact me to discuss these conditions. If I cannot be reached, I consent to having Southlake Crossing Animal Clinic take the steps necessary to help safely care for my pet and I agree to pay for such services.