Sedation Consent Form

Your Pet Will Be Undergoing Sedation for a Procedure or Exam Today

I, the undersigned owner, or agent of the owner of the pet identified above, certify that I am eighteen years of age or over and authorize the veterinarian(s) at this practice to perform the planned procedure(s). I understand that some risks always exist with sedation and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated.

While I accept that all procedures will be performed to the best of the abilities of the staff at this facility, I understand that veterinary medicine is not an exact science and that no guarantees have been made regarding the outcome of this/these procedures.

I agree to assume financial responsibility and provide payment in full via cash, personal check, credit card, or CareCredit at the time my pet is discharged from the hospital. I also understand that during procedure(s) unforeseen conditions may arise. Therefore, I hereby consent to and authorize such procedures as are necessary in the exercise of the veterinarian's professional judgement in such circumstance(s). I also do hereby acknowledge that I understand there are no guarantees either expressed or implied that the procedures planned will be without complications from unexpected events beyond the veterinarian's and hospital's control. I agree to indemnify and hold Northwood Animal Hospital harmless from and against all liability arising out of the performance of any of the planned procedures.

Please do not submit any Protected Health Information (PHI).