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Surgery Release Form

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New Client Form

Brandon Lakes Animal Hospital Surgery Release

I am the owner/agent of the above-described animal and have the authority to execute this consent. I hereby consent and authorize the performance of the above procedure(s) or operation(s)and authorize the performance of other procedure(s) or operation(s) necessary and desired in the exercising of the veterinarian’s professional judgement. The nature of such service has been described to me to my satisfaction and I realize that no guarantee, or warranty can ethically or professionally be made regarding the results or cure. I understand that surgery carries some risk regardless of health status. I have been advised that there is a risk of death every time an anesthetic is used and that possibility, as small as it may be, has been explained to me. In the event of unforeseen complications to include cardiac arrest, I give permission for the doctors and staff to take reasonable measures in treating my pet and accept all charges that are incurred as a result of such action.

Resuscitation Order

Please read the following carefully and initial next to procedures you wish to be performed in the case of an emergency.

Post-resuscitation procedure care most likely will include overnight monitoring at a 24-hour emergency facility at additional cost to the pet owner.

I understand that I assume financial responsibility for all services rendered, and that payment is expected on the day of surgery. Any medications and supplies purchased will be at an additional charge.