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Spay/Neuter Consent Form

Save time ahead of your pet’s procedure by completing our required Spay/Neuter Consent Form online.

Spay/Neuter Consent Form

Please complete this form as accurately as possible so we can proceed with your pet’s care.

Contact during Contact

This form is for the purpose of authorizing our hospital to perform a spay/neuter procedure on my pet. By signing this form, I certify that I understand further complications can occur during these procedures and authorize the hospital to administer additional treatments if such complications were to occur.

Contact Name *

First

Last

Contact Phone Number *

Emergency Phone (If different from Contact Phone)

Contact Email Address *

Pet Name (First Name Only) *

Pet Species *

Pet Breed

Client Consent For Anesthesia, Surgical and Treatment Release

I am the owner of the above named animal, and hereby authorize the treatments discussed with the hospital; I also authorize the use of anesthetic agent as are deemed necessary to perform the above procedures(s). *

I have read, understand, and agree to the above statement.

I acknowledge and understand that as a result of the performance of the procedure(s) described above, there is a material risk that the patient may suffer from complications including but not limited to infection, allergic reaction, blood loss, loss of function of limb or organ, paralysis or paresis, weakness, tissue scarring, brain damage, cardiac or respiratory arrest, or death. *

I have read, understand, and agree to the above statement.

I also authorize the administration of such additional treatments and surgical procedures that are considered therapeutically and diagnostically necessary on the basis of findings during the course of evaluation and/or treatment. *

I have read, understand, and agree to the above statement.

I assume financial responsibility of all charges incurred on behalf of the patient. *

I have read, understand, and agree to the above statement.

By signing below, I acknowledge I have read or have had explained to me and understand this form and I voluntarily consent to the performance of the procedure(s) described or otherwise referred to herein. *

I have read, understand, and agree to the above statement.

I have been informed of the importance of pre-anesthetic tests and understand the potential risks. *

I have read, understand, and agree to the above statement.

Any female patients who are in heat, pregnant, or have recently had pups may incur additional charges.

If external parasites (fleas/ticks) are present upon admission to the hospital, appropriate treatment will be administered at the owner’s expense.

Today's Date *

Signature *

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*This promotion is valid for new clients only and may be used once per client. Cannot be combined with other offers or promotions. Other restrictions may apply.

Spay/Neuter Consent Form

Client Consent For Anesthesia, Surgical and Treatment Release

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