CONSENT FORM

I understand my pet is being admitted to the hospital for the abovementioned

procedure(s). I have discussed the recommendations of the

hospital with the technician and/or doctor prior to today.

I understand that it is this hospital’s policy that all patients have preanesthetic

blood work performed. The blood panels listed below are offered

to give the doctors pertinent information about how your pet, potentially,

will handle the anesthesia. Additionally, we offer another pre-surgical

medical testing such as radiographs, EKG and ultrasound at the doctors

discretion. If these tests are recommended, we will call for your approval.

• Juvenile Wellness (Must be under 6 years)

• Pre-surgical Wellness

• General Health Profile (Complete Panel for Sick/Geriatric Patients)

A microchip can be implanted below your pet’s skin for identification

purposes. While it can be done awake, we prefer to do it while under

anesthesia due to the size of the injection syringe.

CPR/DNR Orders

I expect the doctors and staff of Absecon Veterinary Hospital to use all

reasonable precautions regarding the safety of my pet, but I understand

there is always a potential risk with anesthesia.