We will have new days and hours of operation as of March 2024.Hours will be from 8:00 am-5:00 pm. Our doctors will provide care full-time each day that we are open for improved access.</marquee >

Anesthesia Consent Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Get Started

Anesthesia Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 775-870-1800 for a faster response.

Client Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Patient Name *

Species *

Sex *

Male
Male (neutered)
Female
Female (spayed)

Color *

Weight *

Anesthetic and surgical procedure(s) to be performed:

I, the undersigned owner or agent of the pet identified above, authorize the staff of Monte Vista Animal Hospital to perform the above procedure(s).

I understand that some risks always exist with anesthesia/sedation and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated.

I give my permission for anesthesia/sedation and/or surgery.

I do
I do not

CPR (Cardio Pulmonary Resusitation)

I understand that the attending veterinarian will make every effort to contact me regarding treatment in the case of unforeseen emergencies. If unable to contact me, the staff may or may not have my permission to proceed with life-sustaining procedures.

I give permission to perform CPR on my pet.

I do
I do not

While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved.

I also assume full responsibility for any additional expenses incurred after the surgical procedure is performed, such as follow-up radiographs, re-check physical exams, and additional surgery due to post-op complications. These are more likely to occur when there is a failure to comply with the aftercare instructions.

A complete physical exam will be performed on your pet prior to the surgical procedure. However, this may not identify all systemic or metabolic problems. For this reason, your pet will have a pre-anesthetic blood panel to evaluate major organ functions prior to anesthesia.

I have read and fully understand the terms and conditions set forth above.

Signature *

Clear Signature

Date *

Anesthesia Consent Form

Anesthesia Consent Form

Make a Veterinary Appointment

Contact Monte Vista Animal Hospital

Contact Information

Hours

Address: