Open Mon-Fri: 8:00AM to 5:00PM, Sat: 8:00AM to 1:00PM

Make an Appointment 706-283-2761
Make an Appointment 706-283-2761

Open Mon-Fri: 8:00AM to 5:00PM, Sat: 8:00AM to 1:00PM

Make an Appointment 706-283-2761
Make an Appointment 706-283-2761
All Creatures Veterinary Services
Make an Appointment 706-283-2761
Make an Appointment 666-666-6666
Pet Townsend Veterinary Clinic

Specialized Sedation Consent Form

"*" indicates required fields

Owner's Name*
Species*
Sex*
Please list any medications not prescribed by All Creatures Veterinary Services that your pet is currently taking, including over the counter medication.
PLEASE NOTE: ALL PATIENTS WILL RECEIVE A CAPSTAR UPON ARRIVAL IF FLEAS ARE PRESENT*
ALL PATIENTS HAVE TO BE UP TO DATE ON ALL VACCINE*

Additional Surgical Options:

Laser Therapy: One time treatment after surgery to promote wound healing and decrease pain/inflammation. The cost is $10*
IV Catheter: All patients will receive an IV Catheter to help increase the safety of the procedure(s) if necessary. This will allow instant access for emergency medications in the event an emergency occurs.*
Pre-Anesthetic Bloodwork: Pre-Anesthetic bloodwork is recommended to screen for existing disease that could be made worse by anesthesia or that could interfere with a pet’s recovery from anesthesia. Bloodwork is highly recommended if your pet is 7 years or older.*
Please complete the mini panel of bloodwork you are recommending prior to surgery on my pet at the additional cost of approximately $110.00 depending on the patients specific needs.*

OR

Please complete the full panel of bloodwork you are recommending prior to surgery on my pet at the additional cost of approximately $247.00 depending on the patients specific needs.*
Pain Medication: All Surgery patients will receive a pain medication injection that is included in the price of their surgery. However, that price does not include additional pain medication to be sent home with the patient (which you, the owner, will administer). Depending on the patients weight the price will vary.*
Yes, I understand there will be an additional fee for pain meds as recommended by the doctor.*

I understand that during the performance of this procedure, unforeseen conditions may be revealed that necessitate an extension or variance in the procedures set forth above. I expect All Creatures Veterinary Services to use reasonable care and judgment in performing the procedure(s). The nature of the procedure and risks has been explained to me and I realize results cannot be guaranteed. While All Creatures Veterinary Services strives to provide the highest quality in anesthesia monitoring and surgical care, I understand there are rare complications associated with any procedure(s) will not relieve me from my obligation to all reasonable costs (including IV fluids, IV medications for heart rate or breathing abnormalities, etc.) incurred regarding the animal, and I am aware that payment is due at the time of service.

I have read and understand the above statement.*
I understand that all estimates are approximate and therefore not guaranteed.*
As the owner of this pet, I hereby give my consent to veterinarians of All Creatures Veterinary Services to perform the above stated procedure.*
Clear Signature
MM slash DD slash YYYY