Dental Surgery & Anesthesia Release Form

Surgery/Procedure: DENTAL

• 1. Permission to admit patient and perform procedure(s): I, as owner or owner’s representative, authorize the above procedures to be performed for my pet. If any unforeseen medical needs arise and I am not available, I grant permission for any necessary care to be administered.
• 2. Pain Control: In order to reduce the anxiety and discomfort to your pet that is associated with surgical procedures, a pain injection is given to all of our surgery patients. These analgesics can improve healing and recovery by reducing the physiologic effects of stress and pain on your pet.
• 3. Pre-Anesthetic Bloodwork: Your pet is scheduled for a procedure that requires anesthesia. We would like to take this opportunity to explain the use of pre-anesthetic testing and it’s importance to the health of your pet.

Like you, our greatest concern is the well being of your pet. Before placing your pet under anesthesia, a veterinarian will perform a pre-anesthetic physical to help identify existing medical conditions that could complicate the procedure and compromise the health of your pet. It is important to understand that a pre-anesthetic profile does not guarantee the absence of anesthetic complications. It may, however, greatly reduce the risk of complications as well as identify medical conditions that could require medical treatment in the future.

Because there is always the possibility a physical exam alone will not identify all of your pet’s health problems, we strongly recommend that a pre-anesthetic profile (a combination of tests) be performed prior to anesthesia. The tests we process are similar to and equally as important as those your own physician would run if you were to undergo anesthesia.

For pets 3 yrs and above:

The combination of blood tests we require for the older pet is: CBC, BUN, Creatinine, ALK, ALT, Glucose, Total Protein (Kidneys, Liver, Diabetes, Hydration, Protein, Infection, Anemia). $ 72.00