Anesthesia Website Consent Form

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Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

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Anesthesia Website Consent Form

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


You may use the PDF version by clicking the DOWNLOAD FORM button and then completing the printed form by hand. Please bring the completed PDF form with you for your pet’s first appointment.


Your pet will be scheduled for a procedure that requires anesthesia, though very unlikely, anesthesia inherently carries some risk. Therefore, we would like to take this opportunity to explain why pre-anesthetic blood testing will be performed and why it is important to the health of your pet. The anesthetic agent is removed from the body by the liver and kidneys, so it is important to know before anesthesia that these organs are functioning at 100%. Like you, our greatest concern is the well-being of your pet. Before putting your pet under anesthesia, a veterinarian will perform a full comprehensive physical examination to identify any existing medical conditions that could complicate the procedure and compromise the health of your pet. There is always the possibility that a physical exam alone will not identify all your pet’s health problems. The pre-anesthetic blood profile (a combination of blood tests) is performed prior to anesthesia. This blood profile that we complete in our lab is similar to, and equally as important as those your own surgeon would run if you were to undergo anesthesia. Results will be immediately available before general anesthesia and/or surgery. The cost of this pre-anesthetic blood profile is included in your estimate. It is important to understand that a pre-anesthetic blood profile does not guarantee the absence of complications. It may, however, greatly reduce the risk of complications that could require medical treatment in the future. If your pet is geriatric or ill, we strongly recommend upgrading to a full comprehensive blood screening.

ECG Safety Option for All Pets:*

We offer electrocardiogram (ECG) to all patients as part of the pre-surgical work-up. An ECG is a diagnostic tool used to screen patients for the presence of hidden heart disease and/or arrhythmias that can form at any age. ECG’s are conducted the morning of surgery. Anesthesia protocols are often based on the findings of these reports. ECG’s are optional, but highly recommended tools to ensure a favorable outcome for your pet’s procedure.

AVID Microchip for All Pets: *

Please click to acknowledge the following statements:

MISC: Please list the name and indicate the time the last dose was given for any medication your pet is currently on.

Please bring these medications with you on the day of surgery.