Surgery Release Form

Anesthesia/Surgery Release

Procedure.

Advances in anesthesia have made elective procedures safer, with a low rate of anesthetic complications. However, complications can arise because of undiagnosed pre-existing conditions. At Blue Door Veterinary Services, we do everything we can to prevent complications including a pre­anesthetic examination and blood work screening prior to the procedure. In certain rare circumstances, a condition may exist that is not evident on physical examination or pre-anesthetic screening, which could result in an anesthetic complication. To help avoid complications, all patients undergoing anesthesia will have an intravenous catheter placed to allow for administration of fluids during the procedure (to help support blood pressure) and to facilitate emergency treatment if needed. It may be necessary to shave or clip hair from the IV catheter site and/or other areas. Patients will be monitored during and after anesthesia. Pain relief medication will be administered in hospital and dispensed for use at home at the discretion of the doctor.

Blue Door Veterinary Services requires pre-anesthetic screening prior to all anesthetic procedures. This information helps us know whether we need to take additional precautions with your pet or postpone the procedure pending treatment. All costs associated with pre-anesthetic testing are included in your surgery procedure cost; however, if the procedure is postponed due to the results of the testing or examination, you will be billed separately for the testing that was completed.

While your pet is under anesthesia, there are some procedures you may elect to have performed for your pet's safety and comfort. These services are charged in addition to the procedure cost if chosen.

Microchips are a means of permanent identification should your pet get lost.

With my signature below, I certify that I have read, understand and agree to the above statements and authorize Blue Door Veterinary Services, LLC to treat my pet as written above.

Phone: 503.819.8040
Fax: 503.777.2788
E-mail: info@bluedoorvet.com

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