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Anesthesia Release Form.

Before any procedure that requires anesthesia, we ask you to review and complete this consent form. Our team will walk you through what to expect, and we are always glad to answer your questions before signing.
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What the Form Covers

  • Confirmation of your pet’s current health and any recent changes
  • Current medications and any known allergies
  • Pre-anesthetic bloodwork and recommended diagnostics
  • Authorization for anesthesia, pain management, and any additional care needed during the procedure
  • How and when our team will reach you during and after the procedure
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Complete the Form

Fill out the form online below, or download a printable copy to review at home.
Download a Printable Copy
I understand, although all reasonable precautions and due care will be taken during treatment of my pet, there is always a potential risk in anesthesia surgery and I accept these risks. I understand that conditions may arise during this procedure whereby a different or additional procedure may need to be performed; and I authorize the doctors to do what they feel is needed and necessary. I understand that no guarantee of successful treatment has been made. I certify that I understand that release and will assume full financial responsibility of all charges.

All pet’s staying with Liberty Hill Veterinary Wellness will be checked for fleas and if positive shall receive a Capstar. Cost of this treatment is $15. In order to reduce stress and minimize bacterial infection during blood draws and catheter placement, we may need to shave a small patch of fur from your pet’s leg and/or neck.

Clear Signature

Questions Before You Sign?

We want you to feel fully informed about your pet’s procedure. If anything is unclear, please reach out before the day of surgery.

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