Standard Surgery Consent Form

Save time during your appointment! Complete your standard surgery consent form online from any device before your visit.

Get Started

Standard Surgery Consent Form

Before surgical procedures, we will require your review, authorization, and signature of this form.

Owner’s Name *

First

Last

Email *

Phone number where you can be reached: *

Secondary phone number where you can be reached:

Pet's Name *

I am the owner or the agent for the owner of the animal described above, and I have the authority to execute this consent. I hereby consent and authorize Dr. Marsch and the staff of East Side Animal Hospital to perform the following procedures or operations: *

I agree

The nature of these operations or procedures has been explained to me, and I understand what will be done. I have also been informed that there are certain risks and complications associated with any operation or procedure of this type. They have been explained to me as well. I further understand that during the course of the operations or procedures unforeseen conditions may arise that may necessitate the performance of additional procedures. I authorize the use of appropriate anesthesia and pain relief medication as needed before or after the procedure. I have been informed that there are risks associated with the use of any medication. I understand that hospital support personnel will be used as deemed necessary by Dr. Marsch. *

I have read and agree

The nature of these operations or procedures has been explained to me, and I understand what will be done.

I have also been informed that there are certain risks and complications associated with any operation or procedure of this type. They have been explained to me as well. I further understand that during the course of the operations or procedures unforeseen conditions may arise that may necessitate the performance of additional procedures.

I authorize the use of appropriate anesthesia and pain relief medication as needed before or after the procedure. I have been informed that there are risks associated with the use of any medication.

I understand that hospital support personnel will be used as deemed necessary by Dr. Marsch.

Signature *

Clear Signature

Date *

Standard Surgery Consent Form

Standard Surgery Consent Form

Ready to Visit?

Questions?

Location

Contact Information

Hours