Dental Treatment Consent

  • Before placing your pet under anesthesia for a professional dental scaling and polishing, we will perform a full physical examination. However, many conditions, including disorders of the liver and kidneys or blood, are not detected unless blood testing is performed. For senior pets, those over 7 years of age, we recommend a more comprehensive general panel. Such tests are important before any anesthetic procedure. For these reasons, we require, at a minimum, the pre-anesthetic panel prior to anesthesia unless, a pre-anesthetic panel, general panel, or wellness panel has been performed within the last 30 days.

  • Please answer the following questions:
  • I certify the following:

    1) I understand the procedure that is to be performed and its accompanied risks; and I authorize the use of appropriate anesthetics, medicines, and diagnostic tests deemed necessary by the doctors for the safe performance of the said procedure.

    2) I understand that unforeseen complications or life threatening situations may occur during the above procedure; and I authorize the veterinarians and support personnel to alter procedure and to provide such treatments, in the doctors' professional judgement, as necessary to safeguard the life and health of my pet.

    3) I understand that I will assume full responsibility for the care of my animal after it is released from the hospital, and that I should and will contact the hospital immediately if questions or complications develop during home care.

    4) In the doctor's professional judgement, as necessary, I authorize treatment of my pet's oral disease including but not limited to: tooth extraction(s), gingival mass resection, and oral infections.

  • I have read and understand the Dental Treatment Consent Form.

  • Email Address
  • Electronic Signature
  • Date
  • Telephone number where I can be reached today