Anesthesia, Surgical and Dental Prophylaxis Release

  • Anesthetic and/or Surgical Procedure

    By signing below, I am authorizing and directing Dr. McPherson, Dr. Fullenwider, Dr. Taylor and/or Dr. Crawford of Tuscawilla Oaks Animal Hospital to perform diagnostics, anesthetic procedures and surgical procedures as deemed advisable or necessary for my pet. The nature of the specific procedure has been explained to me and no guarantees have been made as to the results or outcome. I fully understand that there may be a risk to such procedures. I agree to pay, in full, for the services rendered at the time of service, including those deemed necessary for medical or surgical complications or otherwise unforeseen circumstances. Any estimate of charges or fees for presently planned procedures is only an approximation, and the final bill may be less or greater than this amount. A complete physical examination and pre-operative blood work panel will be performed prior to any administration of anesthesia. While these measures help reduce the risk of anesthetic and/or surgical complications, I understand that there are risks associated with these procedures, including risk of permanent disability or death.
    I have read and acknowledge the above conditions of Tuscawilla Oaks Animal Hospital and have received a copy of this form, if requested.
  • Additional Services

    A permanent method of identification. If your pet is lost or stolen, this system can notify you if your pet is picked up anywhere in the country. The small chip is placed under the skin. This service costs $43.00 (which includes the first year of registration) Ask for details.
    K-laser therapy is a drug free and pain free option to help decrease inflammation and help with post-surgical recovery. If unsure, a technician will go over all details prior to leaving your pet in our care. The cost for this treatment is $20.00. Required for all orthopedic surgeries.
    If your pet is having a dental prophylaxis today this includes a complete oral examination, scaling and polishing, and dental radiographs if indicated. These treatments are included on the treatment plan already presented to you. However, in many instances of advanced dental disease (Stage II, III, and IV), we find diseased, loosened, fractured, or mobile teeth upon oral examination, these teeth typically require extraction, or other treatments, and unfortunately the exact number cannot be determined until your pet is under anesthesia. We will give you an estimated range based on the severity of your pet’s dental disease. If desired, we can attempt to call you during the dental procedure to give you a description of treatments and charges. Please be aware however that this prolongs anesthesia time, therefore if you cannot be reached your pet will have to be recovered from anesthesia and have the procedure at a later date at an additional cost.
  • Date Format: MM slash DD slash YYYY