Sedation Consent Form

Please fill out this form electronically prior to your arrival.

Date

Person Responsible for Care Decisions *

First

Last

Email *

Best number today to reach the person responsible for care decisions *

Pet's Name *

Sedation Consent

I am the owner of the above named animal or am responsible for it and have authority to sign this consent to sedate and treat my pet per the estimate I have been presented. *

I have read, understand, and authorize.

I authorize Family Pet Health to perform procedures on my pet today, and I understand that there may be risks, including death, especially with anesthesia. I expect all procedures to be done to the best of the abilities of the professional staff. I realize that no guarantee or warranty can ethically or professionally be made regarding the results or cure. I also authorize the hospital director and staff to provide veterinary services as requested or in emergency circumstances to follow through with such procedures as necessary for the well being of my pet. I understand that they will contact me as soon as possible with the number provided above in an emergency to discuss cost, but if I am unavailable, emergency procedures or resuscitation procedures are authorized (additional costs may apply). *

I have read, understand, and authorize.

Signature *

Clear Signature

I am the owner or the authorized agent for the owner of the animal described above, and I have the authority to execute this consent. My signature above certifies that I am over eighteen years of age.

Sedation Consent Form

Sedation Consent

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