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HOSPITALIZATION/SURGICAL RELEASE FORM

(All fields with an * are required)

I am the owner or agent for the owner, of the above described animal and have the authority to execute this consent. I hereby consent to and authorize the performance of the hospitalization/surgical procedure.

I understand that during the performance of the foregoing procedure(s), unforeseen conditions may be revealed that necessitate an extension of the foregoing procedure(s) or a different procedure(s) than those set forth. I understand that an effort will be made to contact me at the telephone numbers provided in the event another procedure(s) is performed.

I realize that any procedure involving general anesthesia carries a risk, although very small, of death. If your pet's procedure is not having anesthesia please complete this as a pre-caution due to hospitalization.

Refer to Resuscitative measure options form located under the online forms to see details of the following options.

If applicable-Laser therapy has been proven to improve healing time, reduce pain and decrease swelling. We offer post-surgical laser therapy to surgical incisions for those reasons at a cost of $12.50 Please indicate below by checking YES or No if you would like this additional pain control. To learn more about Laser Therapy please visit http://babcockhills.com/services/laseer-therapy-.html

IF FLEAS OR TICKS ARE FOUND ON YOUR PET AT THE TIME OF ENTRY, YOUR PET WILL BE TREATED AND THE MEDICATION WILL BE REFLECTED ON YOUR INVOICE UPON CHECK-OUT.

If your pet does not have a microchip and is being sedated this is an ideal time to do this procedure. Please refer to the Home Again Microchip online form for details.

I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above-described pet. I assume responsibility for all charges incurred in the care of this animal. I also understand that all charges must be paid at the time services are rendered and that a deposit may be required for surgical treatment or hospitalization.

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