Anesthesia Consent Form

* indicates a required field.

Client Information * Owner's Name:
* Email Address:
* Phone Number:
* Preferred Contact Method:

Pet Information * Pet's Name:
* Species:
Breed:
Age:
* Weight (lbs):

Procedure Details * Procedure to be Performed:
Special Instructions:

Acknowledgment and Consent

By checking the boxes below, you acknowledge and consent to the following:

I consent to the use of anesthesia for my pet during the procedure.
In the event of an emergency, I authorize the veterinary team to perform CPR if necessary.
I understand that there are inherent risks with anesthesia and medical procedures, and I have discussed my concerns with the veterinarian.

Anesthesia Consent Form

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Boca Park Animal Hospital