2 minutes to complete
The person who fills out the consent form should be the owner of the animal. If the person is not the owner, the owner should have given him/her the permission to do so.
Owner's Name
Phone Number
Address
Has your pet been seen by a veterinarian in the last 6 months?
Is your pet up to date on vaccinations?
Is your pet on any medications?
Does your pet have any known allergies?
Does your pet have any known medical conditions?
Has your pet ever had surgery before?
I understand that there are always risks associated with anesthesia and surgery.
I understand that I will be required to sign a separate anesthesia consent form prior to the procedure.
I hereby authorize the staff of the Veterinary Medical Center to perform the following diagnostic and/or therapeutic procedures on my pet.
Client's Signature