Procedure Consent Form

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.