Surgical Consent Form printable pdf download

Gainesville Veterinary Hospital

1363 Thompson Bridge Road

Gainesville, GA 30501

770-532-0491

Surgical Consent Form

Owner’s Name:

_________________________________________________________________

Street:

_________________________________________________________________

City, State, Zip:

_________________________________________________________________

Phone:

_________________________________________________________________

Pet’s Name:

_________________________________________________________________

Breed:

_________________________________________________________________

Sex, Age:

_________________________________________________________________

Color:

_________________________________________________________________

I, the undersigned, authorize ______________________________________________surgery for my pet.

The nature and risks of this procedure have been explained to me. I understand that some risks exist with

surgery and I am encouraged to discuss any concerns associated with risks with my veterinarian before

the procedure(s) are started. My signature on this consent form indicates that questions have been

answered to my satisfaction.

I authorize Gainesville Veterinary Hospital to perform any additional diagnostic, treatment or surgical

procedure(s) deemed necessary for medical or surgical complications or any unforeseen circumstances.

While Gainesville Veterinary Hospital provides the highest quality of anesthesia monitoring and surgical

services, I understand the risks and understand that the veterinarians and hospital team will do everything

possible to reduce any risks. I will not hold Gainesville Veterinary Hospital, the veterinarians or any

team member liable for any complications that may arise.

I HAVE READ AND FULLY UNDERSTAND THIS SURGERY CONSENT FORM.

Signature of Pet Guardian: _______________________________________Date: ___________________

Phone number where I can be reached: _____________________________________________________

Surgical Consent Form