Anesthesia Consent Form

Save time at your pet’s surgical appointment by completing your required anesthesia consent form online or printing a copy to bring with you.

Anesthesia Consent Form

Accurate information is essential for your pet’s safety please complete all sections carefully before your pet’s procedure at Potlatch Veterinary Clinic.

You may use the PDF version by clicking the DOWNLOAD FORM button and then completing the printed form by hand. Please bring the completed PDF form with you for your appointment.

All anesthetized/sedated procedures include a pre-anesthetic physical exam, nail trim, internal ear exam, IV catheter, anesthetic monitoring and recovery monitoring.

Secondary contact

Note: If your pet is over 10 years old, IV fluids and a pre-anesthetic blood panel are highly recommended and may be required by the veterinarian for the safety of the patient.

Intravenous (IV) Fluid Support

Therapeutic Laser Post-Surgical Incision Treatment

Cardiopulmonary Resuscitation (CPR): Informed Consent

Additional Services

Pre-anesthetic/Sedation History

If yes, please provide the following details

By signing this document I have carefully read and understand the terms and conditions set forth by Potlatch Veterinary Clinic and agree to all the above statements.

Clear Signature