Elective Surgical Procedure Request Form

Please review and complete this form before your pet’s scheduled surgery.
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Plan Your Pet’s Procedure

We are dedicated to making your pet’s surgery as safe and stress-free as possible. This form confirms your pet’s readiness for anesthesia, outlines optional services, and ensures we have your consent for all procedures performed while your pet is in our care.

While My Pet is Under Anesthesia, I Give Consent for the Following Procedures:

Authorization

I am the owner or authorized agent for the pet presented for surgery/hospitalization and have the authority to execute this consent. I have been given an estimate of the cost of treatment and understand that payment is due when my pet is picked up. If this form is signed prior to surgery, I understand there is a $25 non-cancellation fee.

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