General Surgery Consent

Surgical/Anesthetic Options: Please initial your choice for each option.

Laser Surgery: We have the ability to use a surgical laser rather than a scalpel blade for most routine procedures. This may decrease bleeding, swelling, and postoperative pain.

Required by veterinarian

I elect laser surgery for my pet (cost: $75.00)

I decline laser surgery

Therapeutic Laser Treatment: This treatment can be performed on your pet’s incision(s) postoperatively to reduce pain and aid in the healing process on a cellular level. (Not used on any growth removals)

I elect therapeutic laser treatment for my pet (cost: $13.50)

I decline therapeutic laser treatment

Microchip Permanent Identification: A microchip is a means of permanent identification that is implanted under the skin. If your pet is lost, your pet may be reconnected with you via the use of a chip scanner (most veterinary clinics, shelters and rescue organizations have one of these scanners).

I elect to have my pet microchipped (cost: $51.75)

I decline microchipping

E-Collar (Cone to keep the patient from licking):

Decline

Sedative to go home

Decline

Consent for Anesthesia/Sedation and Surgery

I, the undersigned, am the owner or authorized agent of the pet listed below, and am at least 18 years of age. I elect to
have this pet undergo the anesthetic and surgical procedure listed below, and declare that I understand the procedure along
with associated benefits and risks (up to and including death) as outlined above, and I have had the opportunity to have my
questions regarding the procedure answered.

Pet's Name

Date

MM slash DD slash YYYY

Species

Date of Birth

MM slash DD slash YYYY

Sex

Male

Female

Surgical Procedure(s):

The estimated price range for this procedure is between: $

Initial