Anesthesia/Surgery Release Form

Save time at your first appointment! Complete your required anesthesia/surgery release form online before your visit.

Anesthesia/surgery release form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

Client Name(Required)
I hereby understand that my pet will be undergoing anesthesia and surgery based on the recommendation of my vet.(Required)
Anesthesia Risk Acceptance:(Required)
Surgery Risk Acceptance:(Required)
Post-Operative Care:(Required)
  • Medication administration: I will administer all prescribed medications as directed, at the correct dosage and frequency, for the full duration of the treatment.
  • Activity restriction: I will restrict my pet's activity as advised, preventing running, jumping, and excessive play to allow for proper healing.
  • Incision care: I will monitor the incision site daily for any signs of infection or complications and keep it clean and dry as instructed.
  • Dietary management: I will follow the recommended dietary guidelines, including any changes to food type or feeding schedule.
  • Follow-up appointments: I will attend all scheduled follow-up appointments to ensure my pet's recovery is progressing as expected.
(Required)
Risks associated with specific medical
Procedures:
Clear Signature
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