General Consent Form

  • Pampered Pets Veterinary Clinic and Spa


    J. Brian Ledger, DVM
  • MM slash DD slash YYYY

  • General Consent Form

    What method of communication would you prefer:
  • Risk associated with not using an Elizabethan (e-collar) Collar:
    Elizabethan Collars (e-collars) are used as a tool to help pets heal quickly and safely after medical/surgical procedures. A dogs/cats nature is to lick and bite areas of discomfort, which can lead to infection or opening of the surgical incision. While it may appear an inconvenience to leave this on for the duration of the recovery, it is medically required for proper healing.
  • Consent for Treatment or Surgery:
    I hereby authorize and direct the veterinarian of Pampered Pets Veterinary Clinic & Spa to perform the above described procedure(s). The nature and purpose of the procedure(s) has been explained to me and I understand that no guarantee exists as to the result of diagnosis and treatment of the said animal. I agree to pay, in full, for services rendered, including those deemed necessary for medical or surgical complications or unforeseen circumstances. If unforeseen conditions arise, in the judgement of the attending veterinarian, call for procedures or treatments other than those now being authorized. I authorize such procedures if reasonable efforts to contact me for further consent are unsuccessful. I understand that while the anesthetic used in this hospital is one of the safest used in veterinary medicine, NO anesthesia is without medical risks. No guarantee can be made legally, or ethically to me on the outcome of any procedure performed.
    I have read and understand this consent.

    I herby certify that I am over the age of 18 and the owner or decision maker of the above-named animal and have the authority to execute this consent.
  • MM slash DD slash YYYY

Dental Consent Form

  • Pampered Pets Veterinary Clinic and Spa


    J. Brian Ledger, DVM
  • MM slash DD slash YYYY

  • Dental Consent Form

    All surgical procedures require a basic lab panel be done prior to any surgery. Expanded lab panel may be required due to any prior illness or age.
  • All food and water need to be pulled no later than 10pm the night before the procedure. Drop off times are in between 7 and 9 am, and pick up is in between 4 and 4:30

  • Procedure(s):

  • Dental Extractions:
    It is difficult to fully examine a pet’s teeth without sedation. Therefore, there may be a possibility that your pet will need extractions. If this is the case, all possible steps will be taken to get into contact with you during the surgery. If we are unable to reach you, no extractions will be performed, and they will need to be done at a later date. Extractions can cost $35-$395 per tooth depending on the tooth and its disease status.
  • Consent for Treatment or Surgery:
    I hereby authorize and direct the veterinarian of Pampered Pets Veterinary Clinic & Spa to perform the above described procedure(s). The nature and purpose of the procedure(s) has been explained to me and I understand that no guarantee exists as to the result of diagnosis and treatment of the said animal. I agree to pay, in full, for services rendered, including those deemed necessary for medical or surgical complications or unforeseen circumstances. If unforeseen conditions arise, in the judgement of the attending veterinarian, call for procedures or treatments other than those now being authorized. I authorize such procedures if reasonable efforts to contact me for further consent are unsuccessful. I understand that while the anesthetic used in this hospital is one of the safest used in veterinary medicine, NO anesthesia is without medical risks. No guarantee can be made legally, or ethically to me on the outcome of any procedure performed. I have read and understand this consent
  • I hereby certify that I am over the age of 18 and the owner or decision maker of the above named animal and have the authority to execute this consent.