Anesthesia Consent Form

Your pet’s health, safety, and comfort are our primary goals.

All of our surgical patients receive pain medications before, during, and after surgery. We require the placement of an IV catheter and use of IV fluids during all anesthetic procedures. The IV catheter allows for rapid administration of drugs should an emergency situation arise. The intravenous fluids help prevent low blood pressure and dehydration during surgery, which facilitates a quicker recovery from anesthesia.

Blood testing is done on all patients prior to anesthesia $53.50

Disorders of the liver, kidneys, low grade infections, or electrolytes abnormalities can only be detected through blood testing. Detection of these conditions prior to surgery will decrease the risks associated with anesthesia.

Anesthesia monitoring is done by a trained veterinary technician. Your pet’s heart rate, pulse oximetry, respiratory rate, oxygen levels, and temperature will be monitored during surgery and throughout recovery.
Microchip placement during surgery. $40
- Yes
- No
Nail trim, ear cleaning, and anal gland expression. $20.75
- Yes
- No
Laser Therapy post-surgically for Pain Management and Accelerated Healing $12
- Yes
- No
I understand the procedure to be performed on my pet and have no further questions at this time. I acknowledge there may be concealed health risks to my pet and release Northampton Animal Clinic from any unforeseen complications arising from anesthesia/surgery. I will be available at the phone number below at all times during the day of the procedure. If I can’t be reached by phone, I agree to allow any treatment deemed necessary for the health of my pet.
Date:
Pet’s Name:
Surgical Procedure:
Owner Name:
Owner Signature:
Day time Phone:
Cell Phone:

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Anesthesia Consent Form

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Open 5 Days A Week!Monday – Friday: 8AM – 1PM & 2PM – 5:30PM

Open 5 Days A Week!
Monday – Friday:
8AM – 1PM & 2PM – 5:30PM