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Surgery Consent Form

Save time during your next appointment. Complete your required forms online from any device at any time before your visit.

Surgery Consent Form

Welcome to West Main Animal Hospital

Thank you for selecting our veterinary healthcare team!

We strive to provide you with the best possible care for your pet. To help us meet all your veterinary care needs, please fill out this form completely. If you have any questions or need assistance, we will be happy to help.

My signature below verifies the following:

A) The diagnosis, medical/surgical care and post surgical care has been described to my satisfaction.

B) A financial estimate has been prepared for me. I understand these expected costs are only estimates and that situations can arise that would alter the actual medical cost.

C) I accept that all medical/surgical procedures involve some risk. I understand that these risks include but are not limited to:

  1. General anesthesia. I realize that some patients may have adverse reactions to anesthesia that may result in permanent injury or death.
  2. Infections can complicate wound healing. I realize that despite all precautions, a small percentage of patients may develop infections. I understand that these patients require additional medical care, which is not covered in my medical estimate.
  3. Unexpected outcomes. I understand that no promises or warranties can be given. I realize that complications can occur at any point during the procedure or the healing process. I accept that some complications can prevent my pet from achieving the outcome I had hoped for.

Signature of Responsible party

**Please discuss the below options with a doctor or technician**