Consent for Soft Tissue Surgery

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This field is for validation purposes and should be left unchanged.
MM slash DD slash YYYY

I am the owner or the authorized agent for the owner of the animal described above, & I have the authority to execute this consent. My signature below certifies that I am over 18 years of age.

I have been informed that there are certain risks & complications associated with sedation, anesthesia, and/or any operation/procedure and that the risks/complications have been explained to me. I further understand that during the operations or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures deemed necessary by the veterinarian. I am encouraged to discuss any concerns I have about these risks with the attending veterinarian before the procedure is initiated.

I authorize the use of appropriate anesthesia & pain relief medication as needed before, during or after the procedure. I have been informed that there are risks associated with the use of any medication.

The nature of these operations or procedures has been explained to me and I understand what will be done. I am aware that the practice of veterinary medicine is not an exact science &, thus, there are no guarantees for successful treatment. I have been encouraged & given the opportunity to discuss any questions I may have regarding my pet's medical care & my questions have been answered to my satisfaction. I accept that my financial obligations remain regardless of the outcome.

Name*
I have read & understand this authorization & hereby accept & agree to the terms of the consent for treatment.
CPR*

In the event that your pet should experience cardiac or respiratory arrest while being hospitalized today, do you give consent for resuscitative efforts to be initiated until you can be contacted further and notified of their status?

By consenting to this service, you are also acknowledging that certain fees will apply. If you are not able to be contacted immediately, resuscitation efforts will be continued to be performed at the doctor’s discretion. Please choice an option below.

MICROCHIP*

Willoughby Veterinary Hospital is not an emergency clinic, which means we do not have overnight staffing. The only emergency clinic in the area is MSU. We are always more than happy to transfer a patient to MSU for 24 hour care and monitoring. In situations where the Dr. on staff feels your pet needs 24 hour care and feels your pet can stay at W.V.H. or financially transferring is not a possibility, we do keep patients overnight knowing there are inhered risks (pulling IV catheter, low body temperature, low blood sugar, fluid overload, etc).

I understand that WVH does not have 24 hour staffing but approve overnight hospitalization if the doctor feels it is in my pets best interest and feels my pet is stable.

LASER*
Used to treat any inflammatory condition. The laser can greatly decrease pain and increase healing. Cost = $25
PICTURES*

**Up to date vaccines (Rabies, Distemper/Parvo, Bordetella for dogs; Rabies and FCRP for cats) and an up to date heartworm test are all required (if no proof of doing them elsewhere) for surgical procedures/prior to going under anesthesia**

**Please note, if your pet is having a spay or neuter, we do routinely apply a small tattoo on their abdomen which indicates they are fixed**