I am the authorized owner of the animal described above, and I have the authority to execute this consent. My signature below certifies that I am over eighteen years of age.
I have been informed that there are certain risks and complications associated with sedation, anesthesia, and/or any operation/procedure and that the risks/complications have been explained to me. I further understand that during the course of the operations or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures deemed necessary by the veterinarian. I am encouraged to discuss any concerns I have about these risks with the attending veterinarian before the
procedure is initiated.
I authorize the use of appropriate anesthesia and pain relief medication as needed before, during or after the procedure. I have been informed that there are risks associated with the use of any medication. The nature of these operations or procedures has been explained to me and I understand what will be done. I am aware that the practice of veterinary medicine is not
an exact science and, thus, there are no guarantees for successful treatment. I have been encouraged and given the opportunity to discuss any questions I may have regarding my pet's medical care and my questions have been answered to my satisfaction. I accept
that my financial obligations remain regardless of the outcome. I agree to pay a deposit of 50% of the estimated cost at time of drop off and assume financial responsibility for the remaining fees, agreeing to provide payment via cash, credit card, Scratch Pay or Care Credit at the time my pet is discharged.
I have read and understand this authorization and hereby accept and agree to the terms of the consent for treatment.
In the event that my pet should experience cardiac or respiratory arrest while being
hospitalized today, do you give consent for resuscitative efforts to be initiated until you
can be contacted further and notified of your pet's status?
By consenting to this service, you are also acknowledging that certain fees will apply. If
you are not able to be contacted immediately, resuscitation efforts will be continued to
be performed at the doctor’s discretion. Please initial your choice below.
Blood work along with a physical examination ensures that a pet is healthy to go under
anesthesia - normal organ function and the ability to clot their blood. Even if a pet is
young, and externally healthy, we can not make general assumptions that internally an
animal is healthy, unless preanesthetic blood work is performed. If blood work is not
elected and your pet has a reaction to anesthesia or medications, Willoughby Veterinary
Hospital can not be liable for any potential complications/ reactions. Bloodwork is
required in any patient 7 years of age or older; there may be additional circumstances in
which the Doctor will require full blood work on pets less than 7 (i.e. pets with seizures,
those taking medications which can affect the kidneys/liver, etc.).
A heartworm test is required in all patients prior to putting them under anesthesia. This is done for the safety of your pet; if a patient is heartworm positive and we don't know, the patient could pass away under anesthesia.
Ideal in all patients; required in dogs > 10yrs, cats > 12 yrs, certain anesthesia
procedures, and/or if there is metabolic derangement. IV catheter ensures IV access. If
there is an anesthetic event, it is very difficult to help a patient if there is not a catheter
already in place. The IV catheter also allows us to use anesthesia that is generally safer.
*Optional depending on the patient*
Used to help maintain blood pressure, heart rate, blood flow to the kidney/kidney
function, and metabolize the anesthesia to make a shorter recovery time.
Willoughby Veterinary Hospital is not an emergency clinic, which means we do not have
overnight staffing. The only emergency clinic in the area is MSU. We are always more
than happy to transfer a patient to MSU for 24 hour care and monitoring. In situations
where the Dr. on staff feels your pet needs 24 hour care and feels your pet can stay at
W.V.H. or financially transferring is not a possibility, we do keep patients overnight
knowing there are inhered risks (pulling IV catheter, low body temperature, low blood
sugar, fluid overload, etc)
Used to treat any inflammatory condition. The laser can greatly decrease pain and
increase healing. Cost = $15
Please note, if your pet is having a spay or neuter, we do routinely apply a small tattoo
on their abdomen which indicates they are fixed.
**Up to date vaccines (Rabies, Distemper/Parvo, Bordetella for dogs; Rabies and FCRP for cats) and an up to date heartworm test are all required (if no proof of doing them elsewhere) for surgical procedures/prior to going under anesthesia**