• Authorization for Medical/Surgical Treatment

    Our greatest concern is the well being of your pet. An examination of your pet will be performed prior to giving any anesthetic. To avoid any potential problems, we will be drawing a small amount of blood from your pet and performing a pre anesthetic blood screen to further protect your pet. Results will be available that same day to determine whether anesthesia should be given.
  • Spay ***If pet is pregnant:*** Do you wish to continue with the surgery? Yes No

    Dental Cleaning/Prophylaxis: If your pet requires extractions Yes No, Call First

  • Pain medication, antibiotics, and anti-inflammatory medications may be recommended to ease the pain and prevent any infection following surgery.

    Pain/Antibiotic/Anti-inflammatory Injections

    Pain/Antibiotic/Anti-inflammatory Medications to go home.

    I understand that anesthesia carries risks and I give Quartz Mountain Animal Hospital permission to place my pet under anesthesia. I authorize the use of appropriate anesthetics, and other medications, and I understand that hospital support personnel will be employed as deemed necessary by the Veterinarian. I realize that results cannot be guaranteed and will not hold Quartz Mountain Animal Hospital staff responsible should my pet expire while under anesthesia. I have read and understand this authorization and consent. Initials

    I authorize today a maximum expenditure of $ prior to speaking to the veterinarian.