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 involves 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 great risk are those 5 - 7 years of age who may have early signs of disease; geriatric animals greater than 8 years old are at high risk of complications associated with anesthesia. $136.50
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. Discounted rate is $35.50 when done in conjunction to surgical procedure, normal laser treatment is $56.00
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.
Histopathology: By preserving, sectioning, and staining the tissue sample with dyes the sample is 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 tumor was completely removed (margins). One site: $292.00 Organ: 552.50
Microchip: If your pet does not already have a microchip, would you like this performed at this time? $41.00

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