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General Anesthetic Consent Form at Animal Health Care Center of Renton

If your pet is scheduled for a procedure that requires general anesthesia, please complete the consent form below. This helps ensure we have your approval and all necessary details to provide safe, effective care.

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Complete the Form

Your Name *

First

Last

Email *

Phone

Date of Procedure *

Pet’s Name *

Procedure to be Performed *

Does your pet have any of the following problems?

Does your pet need any other treatments today?

Vaccines
Heartworm Test
FeLV / FIV Testing
Other

I do hereby authorize to perform a procedure requiring general anesthesia on my animal. *

I do hereby authorize to perform a procedure requiring general anesthesia on my animal.

I am aware of the risks involved and fully release Clinic and Intervet/Schering-Plough Animal Health from any legal and financial responsibilities arising from anesthetic complications. *

I am aware of the risks involved and fully release Clinic and Intervet/Schering-Plough Animal Health from any legal and financial responsibilities arising from anesthetic complications.

authorize involved treatments

Signature *

Clear Signature

Today's Date *

General Anesthetic Consent Form at Animal Health Care Center of Renton

Complete the Form

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