Owner *

Pet Name *

Age or Date of Birth *

Your pet is scheduled for a procedure that requires anesthesia. Like you, our greatest concern is the well being of your pet. We strongly recommend that a pre-anesthesia blood profile be performed prior to anesthetizing your pet today. The results provide vital information about the functions of the blood system and internal organs.

Profile 1 -Patients under age 8

Profile 2 -Sick or Geriatric over age 8
Includes all tests above, and:
Detects disease and provides a detailed evaluation of vital organs and blood system.

By declining, I understand that a medical condition may exist which would be impossible to identify during a physical exam alone. I understand that my pet’s health could be at risk if such a condition goes undetected.

Blood testing authorization *

I authorize the recommended blood testing prior to administering anesthesia.
I decline the recommended blood test

Layout

Would you like to include Microchip Identification? *

20% off

Is your pet current on Vaccines? *

Has your pet been on any pain management/NSAIDS? *

Layout

Permission to treat unforeseen conditions up to $100.00 *

This could include dental extractions, X-Rays, Flea control, IV fluids, antibiotics, etc.

Please contact me prior to authorizing any additional procedures or costs *

I certify that I am the owner or authorized agent for the above animal. I hereby consent to and authorize the doctors and staff at this veterinary practice to admit this pet, and administer anesthesia, surgical procedure(s) and the following procedures as checked above. I have been advised of the nature of the procedures and the potential risks and benefits. I understand that veterinary medicine is an inexact science and that no guarantee of successful treatment can be made.

I acknowledge that I am responsible for payment in full for the above procedures and treatments at the time my pet is discharged.

I will not hold Bayshore Animal Hospital legally liable for any complications.

Telephone number where you can be reached *

Cell Phone Number

Work Phone Number

E-Signature *

Clear Signature

Date of Signature *

Bayshore Animal HospitalDental Consent Form

Dental Consent Form

Make An Appointment

Questions?We're Here to Help

Location

Contact Information

Hours