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Authorization for Anesthetic Procedure(s) and/or Surgery

  • Date Format: MM slash DD slash YYYY
    ***Please note that in some cases we are unable to provide pre-anesthetic bloodwork for certain species of pet. In this case, there will be no bloodwork provided even if your pet is 7 years of age or older.
  • While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that veterinary medicine is not an exact science and that no guarantee or warranty has been made regarding the results that may be achieved. I agree to pay a deposit of 50% of the estimated fees, assume financial responsibility for the remaining fees, and provide payment via cash, credit card, or Care Credit at the time my pet is discharged from the hospital. Should unexpected life-saving emergency care be required, and the hospital staff is unable to reach me, the staff:
  • In the event my pet is hospitalized beyond the first day at this facility, I understand that veterinary care during nighttime hours and/or weekends is provided at the discretion of the attending veterinarian. Continuous presence of personnel may not be provided during these hours. If I desire that my pet have supervision when this facility is closed, I elect to: