Acequia Animal Hospital

Surgery Consent Form

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

acequia animal hospital

SURGERY CONSENT FORM

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. We look forward to meeting you and your pet!

Surgical Consent Form

Name(Required)
I consent to receive SMS text messages from Acequia Animal Hospital. Msg & data rates may apply. Reply STOP to opt-out.(Required)
I am the owner (or authorized agent of the owner) of the animal described above, and have the authority to execute this consent. I understand that some risk always exists with anesthesia, even in apparently healthy animals, including the possibility of death. I have discussed my concerns with the veterinarian and understand that it may be necessary to provide additional medical or surgical treatment to my pet in the event of unforeseen circumstances. I realize that no guarantee, legal or ethical, can be made to me regarding the outcome of any procedure performed. I hereby authorize the use of anesthetics and other medications, as well as any such additional treatment, as deemed necessary by the veterinarian. I understand that hospital personnel will be employed in treating my pet. I have carefully read, and fully understand, this consent. *(Required)
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.