November 27th: Closed
December 24th: 7am - 12pm
December 25th: Closed
December 31st: 7am - 12pm
January 1st: Closed

Surgery Consent Form

Surgery Consent
I understand that during the performance of the above procedure(s), unforeseen conditions may be revealed that necessitate an extension or variance in the procedure(s) set forth above. I expect Triangle Animal Clinic to use reasonable care and judgment in performing the procedure(s). It is understood that anesthesia, surgery, medical treatment, restrain, hospitalization and sedation involve a small degree of risk of death or injury to my pet which the hospital staff has no control over and cannot be held responsible. The nature of the procedure and risks involved have been explained to me and I realize results cannot be guaranteed. I am also aware that unforeseen events resulting from the procedure(s) will not relieve me from my financial obligation to all reasonable costs incurred regarding this animal.
All animals admitted must be: CURRENT ON ALL VACCINATIONS and MUST BE FREE OF EXTERNAL PARASITES. ANY ANIMAL FOUND TO HAVE FLEAS OR TICKS WILL BE TREATED AT THE OWNER’S EXPENSE. Treatments include (but are not limited to): *Capstar *Revolution *Bravecto
Pre-anesthetic blood screen: Due to pre-existing conditions not evident during routine examinations, we recommend that all surgical patients be screened prior to anesthesia by means of laboratory tests. Doing this we can detect anemia, early kidney damage or liver disease, diabetes, or dehydration. Animals at increased risk are those 5 - 7 years of age who may have early signs of disease; geriatric animals greater than 8 years old are at further risk of complications associated with anesthesia: $195.50
Surgical Laser: This option replaces the traditional method of using a scalpel to make incisions by precisely controlling a laser beam that instantly vaporizes the water found in tissues, allowing it to cut. The benefits of using the extreme precision laser results in less pain, minimal bleeding, reduced swelling, lowers the risk of infection and results in a quicker recovery. $217.10
Electric Scalpel (BOVIE® Electrosurgical Unit): Used in human medicine, is the most precise method of cut that controls bleeding by causing the coagulation. May not be appropriate for all procedures: $84.00
Post-op laser treatment: This optional treatment aids in postoperative pain relief and faster surgical site healing using light energy to stimulate inter-cellular activity of the affected tissue. **NOT INDICATED FOR MASSES** Discounted rate is: $44.50 When NOT done in conjunction to surgical procedure, normal laser treatment is $69.50
Dental radiographs: X-rays are available for further evaluation of the teeth and the roots of the teeth that cannot be visualized with the naked eye. Oftentimes, teeth may look normal on the surface but the tooth roots will indicate that oral surgery/extractions are critical to your pet’s health, safety, and to alleviate pain. $136.50
Doxirobe Gel: Is used for treatment and control of periodontal disease. It is applied beneath the gum line to pocket(s) around affected teeth, providing a local antimicrobial effect. It can help reduce periodontal pocket depth, increase gum reattachment, and reduce gingival inflammation. This is on an as needed basis and only used if necessary. $75.10
Extractions: While cleaning the teeth, it may be necessary to extract teeth due to tooth related infection, pain or other oral diseases that cannot be controlled by other means. Extractions are not included in the price of dental cleaning and will be charged based on severity and type of tooth removal.
Microchip: If your pet does not already have a microchip, would you like this performed at this time? $49.50
Histopathology: Preserving, sectioning, and staining the tissue sample with dyes and allows the sample to be examined under a microscope by a pathologist. Laboratory examination can offer an opinion on the likely course of the disease (prognosis). If the entire mass is submitted for examination may also offer an opinion on whether the mass was completely removed (margins). One Site: $341.00 Organ: $680.00

Consent Form for Cardiopulmonary Resuscitation (CPR)

Should my pet Archie require cardiopulmonary resuscitation (CPR), I request that the doctor(s) and medical team at Triangle Animal Clinic pursue such medical care as I have indicated below. Having requested such emergency procedures, I agree to be held responsible for a minimum resuscitation fee to pay for the services performed while the medical team attempts to reach me for further directions. Regardless of my pet’s survival, I agree to pay any and all fees in addition to the other fees already identified by the practice and agreed upon by me.
I request one of the following CPR services (Please check the appropriate choice):
I accept that if the medical team is unable to reach me in 15 minutes they will perform BLS actions in that time frame, and after exercising reasonable medical judgement, determine that there is virtually no hope for medical success, the medical team will cease further CPR procedures. I understand that despite the best efforts of the doctors and medical staff at this facility, even the most successful CPR that restores my pet’s life may not allow my pet to regain his/her normal mentation and physical health, and thus may leave him/her with a poor quality of life. I also understand that even the best CPR efforts of the medical team may still result in my pet’s death.
Less than 6% of pets that experience cardiopulmonary arrest from non-anesthetic reasons, survive to hospital discharge. This percentage increases to 10% survival to hospital discharge after medical teams perform Advanced Life Support (ALS).

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