Surgical Consent Form

Please fill out the new patient form.

First Name

Last Name

Email Address

Phone Number

Pet Name

Procedure

Special Instructions

Like you, our greatest concern is the well-being of your pet. There are always potential risks when undergoing anesthesia and/or surgery. To reduce risks and better ensure your pets safety under anesthesia, we recommend a blood profile and ECG reading be preformed prior. Abnormalities may not be detected unless these pre-anesthetic tests are completed. These tests are similar to those your physician would run on you.

Pre-anesthetic bloodwork gives the doctor more information regarding your pets organ function, alerting us to the presence of infection, anemia, dehydration, diabetes, kidney or liver disease. Our advanced, in- house equipment enables us to perform the pre-anesthetic blood profile the morning of your pets procedure.

Bloodwork completed in the last 60 days won't be repeated unless the doctor deems necessary. *Because of increased anesthetic risk, pre-anesthetic bloodwork is
REQUIRED for all patients 8 years and older*

The pre-anesthetic ECG can identify heart structure abnormalities and irregular rhythms.
Our ECG readings are electronically submitted to a cardiologist with results available within 30 minutes.

We will complete a mandatory therapeutic cold laser treatment following your pets surgery to provide accelerated healing and greater pain management. Therapeutic cold laser is NOT performed on the following surgeries: ocular, mass, lump or tumor removals.

Please select the pre and post surgery options you would like for your pet

Please complete bloodwork recommended prior to anesthesia and/or surgery on my pet. If abnormalities are found, please contact me at the number below. **REQUIRED for all pets 8 yr and older**

Please complete the ECG screening recommended prior to anesthesia and/or surgery on my pet. If abnormalities are found, please contact me at number below.

I have elected to refuse the recommended pre-anesthetic testing at this time. I understand there is increased risks when using anesthesia or performing surgery on an animal that has not had the above testing.

CPR/DNR: Badger Veterinary Hospital requires a CPR/Code status prior to any animal remaining in the clinic without the presence of the owner in the building. If my pet enters a state of Cardiopulmonary arrest, when the heart or breathing stops, I understand that the staff of BVH will make every effort to contact me. In the event, that I am unreachable:

I consent to the initiation of CPR on my pet (additional fees will apply) - I acknowledge that if staff is unable to reach me after initiating CPR for 10-15 mins and if deemed medically necessary, as determined by a doctor, all further CPR procedures will cease.

I DO NOT wish for CPR to be performed on my pet and authorize a Do Not Resusitate (DNR) status.

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Surgery Consent Form

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Surgical Consent Form

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