• DOWNLOAD OUR APP
  • AFTER HOURS EMERGENCIES
  • CONTACT
Wellesley Animal Hospital's logo
Wellesley Animal Hospital's homepage
  • Get In Touch416-966-1830
  • About Us
    • Meet The Team
    • Careers
    • Hospital Tour
    • No-Show & Cancellation Policy
    • What Makes Us Special
  • New Clients
    • Directions
    • Pet Portal
    • Pet Insurance
  • Pet Care
    • Dog & Cat Services
    • FAQ
      • Dental Surgery
      • Neuter & Spay
      • Vaccinations
    • New Pet Owner Information
  • Forms
    • New Client Form
    • Appointment History Form
    • Procedure Consent Form
  • Resources
    • Blog
    • Home Care
    • How-To Videos
    • Payment Solutions
    • Useful Links
    • Wildlife
  • Online Store

NOW ACCEPTING NEW PATIENTS! Contact us to book your pet's next appointment.

Procedure Consent Form

Which practice would you like to register with?

If you would like to attach any medical records you have for your pet, please do so here.
Pet Species*:


PLEASE READ THE FOLLOWING INFORMATION CAREFULLY, AND INDICATE YOUR CONSENT AT THE BOTTOM OF THIS SECTION.


The nature, purpose, and effect(s) of this/these operation(s) and/or procedure(s), as well as the attendant risks and alternatives, have been clearly and adequately explained to me.


I understand that there can be no guarantee as to the animal’s condition or the outcome of any procedure and/or treatment.


I understand that there is always risk inherent to anesthesia. The following precautionary measures have been recommended: fasting, intravenous fluids and pre-surgical blood work; and I have accepted or declined them as stated on the attached treatment plan.


I understand that unforeseen conditions may be revealed during the above procedures, which in the opinion of the attending Veterinarian may require more extensive or different procedures or treatments.


I understand that reasonable efforts will be made to contact me to explain these procedures and/or treatments and obtain my instructions regarding them prior to proceeding. If the efforts to reach me are unsuccessful, I consent to such further operation(s) and/or procedure(s). I understand that I am responsible for all charges incurred.


I consent to the assistance of other hospital personnel at the Veterinarian’s direction, considered necessary or advisable by the attending Veterinarian, in whose care I hereby place my pet.


I understand that Wellesley Animal Hospital is not staffed overnight.

I understand that if my pet(s) should be found to have fleas or other external infectious parasites that s/he will be treated at my cost.

 


I understand that if I should leave my animal(s) for more than 3 days, or their belongings for more than 30 days, that they shall be considered abandoned and will become the property of Wellesley Animal Hospital.

I certify that I have read, have interpreted and fully understand the above, and give my consent for the procedure(s) detailed in the attached treatment plan*:
Would you prefer a regular e-collar, a soft cone, or a surgical onesie for your pet to wear home?*:



If your pet is not microchipped, would you like one administered while they're here today? ($58.28 plus tax)*:

Would you like us to perform therapy laser post surgery? This promotes healing and reduces inflammation. ($29.32 plus tax) *Not applicable to dental procedures or feline neuters* :

Would you like to go home with probiotics (Forti Flora SA)? This reduce chances of soft stool from anesthesia/ medication (10 days worth, $20.70 plus tax)*:

The following questions apply to dental procedures only, please select N/A if not applicable.

 

I prefer to be called before any extractions/treatments are performed* :


If I cannot be reached, I authorize you to proceed with all necessary dental procedures regardless of cost*:


Security Question:
 
 
 

Explore

About UsNew ClientsPet CareFormsResourcesOnline Store

Respecting your privacy

Cookie PolicyPrivacy Policy

Wellesley Animal Hospital


Copyright © 2023 Wellesley Animal Hospital

Company's registered name: Wellesley Animal Hospital

|

Registered Address: 535 Yonge Street, Toronto, ON M4Y 1Y5

Menu

  • About Us
    • Meet The Team
    • Careers
    • Hospital Tour
    • No-Show & Cancellation Policy
    • What Makes Us Special
  • New Clients
    • Directions
    • Pet Portal
    • Pet Insurance
  • Pet Care
    • Dog & Cat Services
    • FAQ
      • Dental Surgery
      • Neuter & Spay
      • Vaccinations
    • New Pet Owner Information
  • Forms
    • New Client Form
    • Appointment History Form
    • Procedure Consent Form
  • Resources
    • Blog
    • Home Care
    • How-To Videos
    • Payment Solutions
    • Useful Links
    • Wildlife
  • Online Store
  • DOWNLOAD OUR APP
  • AFTER HOURS EMERGENCIES
  • CONTACT

Call Us

  • Get In Touch

Our Cookies

We use cookies on our website to make it easier for you to use. Read more.

About Cookies

Our website uses cookies to distinguish you from other users of our website. This helps us to provide you with a good experience when you browser our website and also allows us to improve our website. See our cookie policy.

Cookie settings

We use 3 different types of cookies on our website. You can say which ones you're happy for us to use below.

Functional cookies

These cookies do things like keep the website secure. They always need to be on.

Analytics cookies

These cookies store information about how you use our website, such as what you click on.

Marketing cookies

These cookies do things like tell us if you've seen our adverts on social media, such as Facebook or Twitter.