Arden Animal Hospital

1823 Fulton Avenue
Sacramento, CA 95825

(916)485-5412

ardenanimalhospital.com

SAAC Surgery Release Form

Today's Date (required) :
Client's Name (required)

Pet's Name (required)

Planned Procedure: (required)

Important, please read:
Your pet will be undergoing a procedure requiring general anesthesia today. By signing this form you understand that there are risks inherent to any anesthetic procedure, which may include death. If you have additional concerns about these risks that you feel have not been addressed, please address these with the attending doctor before the treatment is initiated. Your pet’s safety is our primary concern and the following options are protocols that we recommend in order to reduce the risk of anesthesia.
Pre-Aneshetic Blood Work
We recommend blood work prior to anesthesia in order to screen for major organ dysfunction, and screen for potential greater anesthetic risk. Cost is $133.50
Please select one: (required)
I DO want pre-anesthetic blood work for my pet
I DECLINE want pre-anesthetic blood work for my pet


IV Fluids
We recommend intravenous fluid support during surgery to help support kidney function and help maintain normal blood pressure. It also provides direct access to the vein in case of emergency, and is strongly recommended for patients over five. Cost is $104.80
Please select one: (required)
I DO want an IV catheter and fluid support for my pet
I DECLINE an IV catheter and fluid support for my pet


Pain Control ($25-75) (required)
Take Home Pain Control
I DECLINE Take Home Pain Control


Elizabethan Collar
We recommend your pet wearing an Elizabethan collar for 7-14 days to protect their incision from trauma caused by licking or chewing. Cost is $8.00-$18.25
Please select one: (required)
I DO want an Elizabethan Collar
I DECLINE an Elizabeth Collar


Microchip Implantation
This is a permanent form of identification implanted under your pet’s skin. (Registration of microchip is included in price). Cost is $45
Please select one: (required)
I DO want to microchip my pet
I DECLINE to microchip my pet


Important, Please read:
Your signature on this form indicates that you are the owner of the above named animal and have consented to the procedure(s) listed above. I understand that during the performance of medical, surgical or anesthetic procedures, unforeseen conditions may be revealed that necessitate more extensive, costly or additional procedures than originally planned. If the staff at this veterinary hospital is not able to reach me, I consent to and authorize the performance of such procedures as are necessary in the judgment of the attending veterinarian.
I agree to all of the above (required)
Yes
No


Contact Numbers TODAY (required)


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