Anesthetic Release Form

Save time during your appointment. Complete your anesthetic release form online from any device before your visit.

Anesthetic Release Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Owner's Name *

First

Last

Email *

Patient's Name *

Procedure

Last Feeding

Best Phone Number to Contact You Today *

Anesthesia Consent

I, the undersigned, certify that I am the owner, or an authorized agent for the owner, of the animal(s) listed above. I Authorize the Doctor(s) and staff of Huntington Pet Vet to perform the procedures listed above and/or on the estimate for my animal. I also authorize the administration of pain-relieving, sedating, and anesthetizing medications and necessary and appropriate medical, surgical, diagnostic, nursing, and emergency treatments for my animal.

Huntington Pet Vet offers the safest anesthetic and surgical procedures available for your pet. However, there is always an element of risk with any anesthetic procedure, and occasionally, problems may occur during or after any medical or surgical procedure. For example, mild nausea, adverse drug reactions, prolonged recovery, and extremely rare death may occur.

Huntington Pet Vet uses "Isoflurane" as the general anesthesia agent for your pet. This provides superior anesthetic safety and smooth induction and recovery. We also require that all pets have blood tests prior to administering anesthesia. These tests help identify underlying problems that may increase risks to your pet during anesthesia and in the future.

I have read and understand this form and accept responsibility for payment of all charges incurred and services provided to my animal by Huntington Pet Vet.

I have read and understand

Signature *

Date *

Name

Anesthetic Release Form

Anesthetic Release Form

Anesthesia Consent

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Location

Contact Information

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