CONSENT: Anesthesia

Patient Profile

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Please help us provide the best care for your pet by responding to the following questions prior to your pet’s scheduled appointment. Thank you.

Pet has their surgical procedure scheduled soon. We want this day to be as easy as possible for you. Here are a few things to know going into the big day:(Required)



Thank you for reading through this message, and for trusting us .

The Community Pet Healthcare Team

Have/will you withhold food from pet for 8 to 12 hours prior to drop off time?(Required)



What procedure/surgery is pet at Community Pet Healthcare for? (please select all that apply)




Have you reviewed and approved the treatment plan/healthcare plan for pet's procedure and understand that you are responsible for payment in full upon discharge?(Required)


Does pet need any additional services while with us today? (please select all that apply)




Although not anticipated, should unexpected life-saving emergency care be required I would like the hospital staff to attempt the following life saving measures(Required)


We understand that having your pet undergo anesthesia or a medical procedure can feel stressful. Our team is committed to providing the highest level of care and making sure you feel informed and confident throughout the process

As with any procedure, there are potential risks. While rare, these may include:

  • Reactions to anesthesia
  • Bleeding disorders that may not have been previously identified
  • Slower-than-expected recovery
  • Post-operative discomfort
  • Surgical site reactions

Our goal is to minimize these risks through careful evaluation and monitoring. Pre-anesthetic bloodwork is often recommended to help assess your pet’s overall health, screen for underlying conditions, and establish baselines for care. Based on your pet’s age, medical history, and condition, your veterinarian will help determine whether specific testing is appropriate. While helpful, bloodwork is not mandatory for every patient or procedure.

We recognize that blood values can be influenced by many factors – including fasting status, breed, age, and current health. Our medical team will review all test results in context and make any necessary adjustments during your pet’s care. If any unexpected changes or emergencies occur, you authorize our team to provide the treatments needed to stabilize and protect your pet.

By signing below, I confirm the following:

  • I am the legal owner of pet, over 18 years of age.
  • The procedures, risks, and options have been explained, and all of my questions have been answered.
  • I understand that no guarantees have been made regarding the outcome of these procedures.
  • I accept full financial responsibility for all services provided, with payment due at the time of
    discharge.

In the event my pet requires hospitalization beyond the first day, I understand that overnight staffing may not be continuously present. If I prefer continuous overnight care, I may request transfer to a 24-hour emergency facility at my own expense.

I agree with the statement above(Required)


What's Next

  • 1

    Call us or schedule an appointment online.

  • 2

    Meet with a doctor for an initial exam.

  • 3

    Put a plan together for your pet.

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