Anesthesia Surgical Consent Form

Thank you for choosing Eco Deco Pet Hospital for your pet’s surgery. We are committed to your pet’s healthcare, offering personalized service to our patients and families. Our patients are important to our practice, and we appreciate and value your time.

Cancellation/ Rescheduling Policy:
Your pet’s surgery requires the coordination of authorization forms, the surgeon, the anesthesia nurse, and blocking off time from our appointments. Rescheduling requires significant time and expense, particularly if the operating room goes unused due to cancellation.

We require a deposit of $200 to schedule any surgery, 7 days prior to the surgery date. If you choose to reschedule your pet’s surgery, you must do so, 2 days prior to the surgical appointment. The $200 surgery deposit will be forfeited for cancelling and/or rescheduling the surgery date, less than a 2 day notice. If the deposit for any reason was not received prior to the surgery date, a $200 fee will be applied to your account for canceling and/or rescheduling with less than a 2 day notice. If you cancel the surgery a second time, the deposit will be increased to $250.

Pre-anesthetic Testing:
A complete physical examination will be performed on your pet prior to the surgical procedure. However, a physical examination will not identify all systemic or metabolic problems. For this reason, we REQUIRE that your pet have pre- anesthetic bloodwork (and if 7 years or older chest x-rays) to evaluate major organ functions prior to anesthesia. Pre-anesthetic bloodwork is required to be performed 7 days before the surgical procedure. If diagnostics are not ran prior to the 7 days, the surgical appointment will be automatically cancelled at the client’s expense. If there are any abnormalities in the bloodwork or x-rays, the DVM will call you to discuss any changes to the original treatment plan. In other words, the surgery may be postponed, depending on the hospital’s availability.

Bloodwork may only be honored for 7 days; therefore for any rescheduled surgeries the patient will be required to re-run bloodwork at the client’s financial expense.

Medical History:
Patients staying for any length of time at our hospital must be current on their Rabies, Bordetella, & Distemper Parvo vaccinations. Owners and/or caregivers are expected to provide proof of vaccination at the time that the pet is brought to the hospital. If proper documentation is not provided or if the pet is overdue, the pet will be vaccinated accordingly at the owner’s expense. In addition, all dogs scheduled for surgical procedures must provide proof of heartworm testing and prevention. If appropriate documentation is not provided, the pet will be tested prior to the scheduled procedure at the owner’s expense. If your pet has fleas or ticks, it will be treated with a fast acting flea and/ or flea/tick control while in our hospital. Fleas/ ticks are easily spread and put your pet and other patients at risk. If the DVM deems it necessary to administer Nexgard/ Capstar/ or Comfortis to your pet, you will be financially responsible.

Shaving:
The surgical site will be shaved to create a sterile area. A small area on a leg will be shaved to facilitate the placement of an IV catheter. A small area on a leg will be shaved to facilitate the placement of an IV catheter.

Drop Off/Pick-Up:
Drop off for surgery is between the hours of 8am-8:30am Monday – Friday and Saturday at 9am. We do require a minor physical examination at the time of drop off by our Pet Nurse; please allot time in your schedule. The patient must be fasted overnight. Please pick up and/ or remove any food left out for your pet by 12:00pm the night before surgery (except Rabbits). Water can be left out for pets to drink.

You will be contacted after the surgery is completed to schedule a pick up time by text or phone. Please be aware that you must pick up your pet even if not contacted, prior to our closing time. If you are unable to get your pet at the designated pick up time it is your responsibility to contact Eco Deco Pet Hospital to make arrangements. If you cannot come get your pet and the pet has to remain overnight, a boarding fee of no less than $40 per night will be charged. . It is your responsibility to make arrangements to pick up your pet by the designated pick up time. A late fee ($150) will be assessed 30 minutes after the designated pick up time.

Reproductive Complication
Complications, such as the following can occur during your pet’s surgery:

Female dogs experience normal heat cycles and/ or pregnancies that are not always detectable with a physical examination. Unlike dogs, the heat cycles of cats are rarely detectable with a physical examination and can only be confirmed once surgery has commenced. Extra costs are incurred if your pet is spayed while in heat or pregnant, even if it is not detected prior to surgery, due to increased size of and blood flow to the reproductive organs and resulting surgery time.

Occasionally, male dogs and cats experience a condition called cryptorchidism. This occurs when one or both of the testicles remain in the abdomen and do not descend normally. Extra costs are incurred if your pet is cryptorchid due to the additional time and supplies necessary for the surgical procedure.

Retained Juvenile Teeth:
During the pre-anesthetic examination, our DVM and/ or Pet Nurse often discover deciduous teeth retained in the mouths of cats and dogs. Through these teeth are often lost naturally during youth, they can cause future oral problems if retained. It is in the best interest of your pet to have these teeth removed while your pet is under anesthesia for his or her procedure.

Elizabethan Collar:
To ensure that your pet will not chew or lick open the surgical site, an Elizabethan collar is recommended. The pet is required to wear it at all times after the surgery until the post-surgical appointment date. If you decline or do not use the Elizabethan collar, the pet may open the incision, cause infection or may injury itself. Any post-surgical complications will be at the owner’s expense if the Elizabethan collar was declined or not used properly.

Acknowledgment and Consent of Surgical Risks
As the owner and/ or authorized caregiver, I hereby give Eco Deco Pet Hospital consent to perform surgery and/ or treatments for my pet. As the owner and/ or authorized caregiver understand that a surgical treatment plan/ estimate is just an estimated cost and may have added unforeseen costs. I understand that any procedure anesthetic or not, poses a risk to my pet, regardless of health status. While I expect all procedures to be done to the best of the abilities of the professional staff, I realize that no guarantee or warranty can ethically or professionally be made regarding the results or cure. I understand that I assume financial responsibility for all services. Payment is due in full at the time of drop off. My signature on this form indicates that any questions I have regarding the procedure, recovery, or potential complications have been answered to my satisfaction. If an estimate has been presented, I have fully reviewed it for the services that are to be provided. Eco Deco Pet Hospital is to use all reasonable precautions against injury, escape or death of my pet, but is not held liable or responsible in any matter, as I thoroughly understand I assume all risks.