filter comments
Your Name
Pet's name
Phone
Email
Would you like us to call or text you with questions or when your pet is ready to go home?
Call
Text
Alternate contact person
Alternate phone number
Please indicate the date of your pet's procedure.
Procedure for which sedation is required for your pet:
Grooming
X-rays
Wound treatment
Other
If you are having any other procedures preformed, please specify.
Authorizations
Authorizations
I certify that I am the owner/agent of the above-named animal or am responsible for it and have authority to execute this consent. The nature of the sedation procedure has been explained to me. I also agree that after consultation with me, McKinney Animal Hospital's doctors may sedate or anesthetize my pet for the above treatment. I understand that there is a risk involved with sedation, up to and including death. I have been encouraged to discuss any concerns about the sedation and treatment of my pet with the attending veterinarian before the procedures are initiated. Should life-saving emergency care be required and the attending veterinarian is unable to reach me, the staff has my permission to provide such treatment and I agree to pay for such care. I agree to indemnify and hold you harmless from and against any and all liability arising out of the performance of the procedures referred to above and below.
I understand.
I understand that depending on the nature of the procedure or treatment an intravenous (IV) catheter may need to be placed to allow for administration of fluids and/or medications. I understand that a small area of hair will be shaved in order to place the IV catheter.
I understand.
I understand that pain medication may be administered to minimize pain and discomfort. Pain medications can be administered in injection or oral form depending on the disease or condition being treated. I understand the possible need for these medications and consent to their use in my pet.
I understand.
I understand that an estimate of the fees for veterinary services will be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered and during my pet's ongoing medical treatment. I agree to assume financial responsibility for the fees associated with treatment at the time my pet is discharged from the hospital.
I accept.
I have had the opportunity to ask questions and those questions have been answered to may satisfaction.
I accept.
I have read and accept the above stated terms.
I accept.
Today's Date
Submit