Surgery and Anesthesia Consent

Your pet is scheduled for a surgical procedure, which requires general anesthesia. Fill out our Surgery and Anesthesia Consent form below!

Surgery and Anesthesia Consent Form

Please fill out the form below, and a member of our team will get back to you shortly if we have any questions.

I certify that I am the owner or responsible party for the pet listed below. This pet is being assessed or admitted today for a general anesthetic and/or surgical procedure.

Our greatest concern is the well-being of your pet. Before any anesthesia is administered, we will perform a complete pre-anesthetic examination to identify existing medical conditions that could complicate the procedure and compromise your pet’s health. There is always the possibility that a pre-anesthetic exam alone will not identify all health problems. This is why blood testing is required prior to anesthesia. I (or an agent acting on the owner’s behalf) hereby authorize Andover Animal Hospital (or its agents or whomsoever is designated) to perform the above procedure. I understand that there are inherent risks with anesthesia and that a guarantee of a successful outcome cannot be made. These risks have been explained to me as completely as possible within reason. I also understand that Andover Animal Hospital will do their best to minimize these risks through pre-anesthetic blood testing, using the most appropriate and safest anesthetics available, and using state-of-the-art monitoring equipment. Furthermore, I agree to pay the fees for all services rendered at the time the pet is discharged from the hospital. Please sign, recognizing that you have read and understood the risks.