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Informed Consent for Treatment and Surgery/Anesthesia

Please fill out this form as completely and accurately as possible.

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Informed Consent for Treatment and Surgery/Anesthesia

If you have any questions, please feel free to contact us at 775-329-4106. We request that you be patient with our staff as we are working diligently to keep you and our team, as safe as possible when bringing your pet to us. Here are some temporary adjustments that you need to be aware of during your visit today. Our front doors will be locked please do not try coming in.

To evaluate and treat your pet at Fairgrounds Animal Hospital (FAH), the outlined procedures will be performed. This consent form ensures that you comprehend the risks, potential complications, our hospital policy, your financial responsibility, and resuscitation determination.

Read all of the information carefully and completely.
We encourage you to ask questions until you are satisfied with the answers, both medical and financial. If you do not feel comfortable with the procedure(s) outlined, you may consider an alternative course of action. Read each section and write your initials, indicating that you understand, in the spaces provided.
In the event my animal suffers cardiac or respiratory arrest, I authorize the attending clinician to: act in their best judgment
I understand emergency resuscitation requires additional medications and treatments thus additional expense would be incurred for CPR/emergency treatment.(Required)
(dollar amount varies w/ CPR level)
Owner/Authorized Name:(Required)
MM slash DD slash YYYY
FAH Employee Name:
MM slash DD slash YYYY
This field is for validation purposes and should be left unchanged.