Consent for Admission, Treatment, Anesthesia & Surgery
I, the undersigned owner or responsible agent, hereby authorize the doctors at Main Street Vet to prescribe for, treat, anesthetize or perform surgery on the above named pet(s). Should some unexpected life-saving emergency care be required, Main Street Vet’s staff has my permission to provide such treatment and I agree to pay for such care. I understand that anesthesia and surgery are procedures which contain inherent risks. I am encouraged to discuss any concerns about those risks with my attending veterinarian prior to procedures being performed. I agree to assume full financial responsibility for the balance of all services rendered at the time my pet is discharged.
Pre-Anesthetic Bloodwork Consent ($100.00) IV Catheter Placement ($35.00)
Your pet is scheduled for anesthesia and/or surgery. To assure that your pet is in a low risk category, we recommend a screening blood profile. This test can be performed in our hospital the day of surgery. Pre-anesthetic bloodwork helps detect problems that may not be apparent on physical exam. The results will also serve as reference values for the future. IV Catheters are placed for fluid hydration during surgery and quick access to a vein if needed during the surgical procedure.
Profile includes: PCV(anemia), Creatinine&BUN(kidney), Glucose(sugar), T.P.(hydration)ALP&ALT(liver)
Pre-Surgical Check List
• Remove all food after 8:00 pm the night before pets surgery.
• Complete and sign the consent sections of this form.
• Give your pet lots of extra pats and kisses.
• Arrive at the hospital the morning of surgery between 8:00 – 8:30 am
Save This Life Microchips $35.00
While under anesthesia we can microchip your pet. The microchip is the size of a grain of rice and is inserted just under the skin around the shoulder blades. If your pet should become lost, a microchip will identify you as the owner. The cost is $35.00 with no annual registration fee.
A Cerenia injection can be given to your pet. This injection will help to prevent nausea in your pet, encourage them to eat faster after surgery and recover quicker.
Laparoscopy is a minimally invasive surgery option for a multitude of procedures. It uses only a few small incisions, reduced risk of bleeding during and after surgery, less of a need for an Elizabethan collar, faster recovery time and lower risk of infection. With all surgical procedures sometimes incidents arise where the plan of surgery needs to change in the middle of the procedure. For spay procedures it is an Ovariectomy and the uterus is left but should not cause any issues in the future. By signing below you acknowledge the above and give permission to the surgeon to convert the laparoscopic procedure to a traditional surgery if needed.