Anesthesia consent form

Name *

Owner

Vorname

Nachname

I hereby confirm *

that my pet will be nill by mouth on the day of treatment (no food overnight, no breakfast, water may be freely available)

I acknowledge *

that a certain residual risk remains with every anesthetic despite all available precautionary measures taken. This residual risk is increased in your pet (e.g. due to age, breed, size, level of health or pre-existing conditions such as renal disease, heart disease, diabetes, epilepsy etc). The anaesthetic of your pet will be adapted accordingly within the realms of possibility.

I am aware *

that despite taking all precautionary measures, there is still a risk of complications occurring after a surgery (including but not limited to: bleeding, issues with wound healing , reactions to medication, etc.)

I understand *

that if I do not show up for the appointment, cancel the appointment at short notice (less than 24 hours prior) or fail to comply with precautionary measures (e.g. fasting as above) and the appointment has to be cancelled as a result, I will be charged the full cost of the procedure

I confirm *

that following the operation, my dog will be kept on a lead / my cat will remain indoors, for 24 hours, as anesthesia can impair an animal's consciousness for up to 24 hours. Thereafter, I will act according to the individual instructions given.

Forms *

enclosed forms have been read, and recommendations for follow-up care and correct administration of medication during convalescence can be provided for/ensured. If no additional forms were provided prior to the procedure, instructions will be given after the procedure at pickup

Confirmation of availability *

I will be available by telephone during the treatment period of my pet. Should I not be available in case of any enquiries, the treatment decision is at the discretion of the treating veterinarian