Anesthesia/Surgery Consent Form

Save time during your next appointment. Complete your anesthesia/surgery consent form online from any device before your visit.

Anesthesia/Surgery Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.


You may use the PDF version by clicking the DOWNLOAD FORM button and completing the printed form by hand. Please bring the completed PDF form for your pet’s first appointment.


I understand that some risk always exists with anesthesia and/or surgery, including death, and that I am encouraged to discuss any concerns that I have about those risks with the attending veterinarian before the procedure is initiated. Should some unexpected life-saving emergency care be required, the hospital staff has my permission to provide basic life support treatment until the attending veterinarian is able to contact me. I agree to pay for such care. I have read and understand this consent form, and I agree to pay for services rendered at the time my pet is discharged or when service is otherwise completed.

I hereby authorize Aumsville Animal Clinic, LLC and its designated associates to perform the above approved procedure(s). In addition, in the event that emergency treatment is required and I cannot be reached, I agree to any necessary diagnostic testing, treatment, or surgical procedures which are required.

We strive to keep a hospital free of external parasites (fleas/ticks). If your pet has fleas or ticks, we will treat your pet at an additional charge.