Anesthetic Procedure Consent Form

Thank you for trusting us with your pet’s care. Before surgery, we want to ensure you understand the potential risks of anesthesia and surgical procedures.

While most pets tolerate anesthesia and surgery well, complications can occur, including serious outcomes such as permanent injury or death. These risks are similar to those in human medicine. We take every precaution to minimize them.

Possible complications include:
 

• Anesthesia reactions: These may range from mild (nausea, delayed recovery) to severe (irregular heart rate, breathing issues, or, rarely, cardiac or respiratory arrest).

• Aspiration: If stomach contents enter the airway, this can cause serious pneumonia—especially if fasting instructions aren’t followed or if underlying issues are present.

• Surgical risks: Bleeding, infection, poor wound healing, or damage to nearby tissues/organs.

• Pre-existing conditions: Pets with heart, kidney, or liver disease are at increased risk.

• Emergencies: Rare, unpredictable complications may require urgent care or result in death.

We perform a thorough pre-anesthetic exam and recommend diagnostics to guide our care plan. During surgery, your pet is closely monitored by trained professionals using advanced equipment to track vital signs.
 

Though no procedure is entirely without risk, our priority is your pet’s safety and your peace of mind. Please contact us with any questions, we’re here to help.

I hereby give permission for the administration of an anesthetic and to the surgical operation/procedure detailed on this form together with any other procedures which may prove necessary.  The nature of these operations or procedures has been explained to me and I understand what will be done.

I have also been informed that there are certain risks and complications associated with any operation or procedure of this type.  They have been explained to me as well.  I further understand that during the course of the procedure unforeseen conditions may arise that may necessitate the performance of additional procedures. 

We recommend that pre-anesthetic blood work be done prior to anesthesia. It is important to understand that this blood work does not guarantee the absence of anesthetic complications; however, it does reduce the risk of complications as well as identify medical conditions that could require medical treatment in the future. The chemistry analysis informs the doctor of your pet’s organ function and hydration status. The complete blood count reveals possible anemia, infection or blood clotting problems.