Pet Procedure Consent Form - Chiswick

Please indicate the surgery you would like to drop off and pick up your pet.

I hereby give permission for the administration of an anaesthetic, to the above mentioned animal and to the dental procedure detailed on this form, together with any other procedure which may prove necessary.

• I hereby give permission for the administration of an anaesthetic, to the above mentioned animal and to the dental procedure detailed on this form, together with any other procedure which may prove necessary.
• The procedure, associated costs, potential risks and complications have been explained to my satisfaction. I understand there are some risks involved in all anaesthetic and sedation techniques and with all surgical procedures.
• I accept the cost is likely to be as estimated. If further treatment is required or complications occur, Young Veterinary Partnership will always act in the best interests of my pet, obtain my consent as soon as practical and that this could incur additional costs.
• I understand the vet may decide to use medicines that are not licensed or authorised for use in my pet's species and I give my consent for this.
• I understand that as a registered and approved training practice, veterinary (nursing & medicine) students may be involved in the care of my pet and I consent to this.
• In the event my pet requires overnight care, continual monitoring cannot be achieved. However, I am aware that the staff on duty will make checks as necessary as determined by the condition of the patient; our staff are not present on site overnight.
• I understand that I am liable for all fees relating to this procedure. I understand the costs and Tiers / pricing structure associated with my pets treatment. I understand that Young Veterinary Partnership will always try to provide the most accurate pricing structure prior to the procedure but prices may change after X-rays and or probing of teeth and gums which can only be performed under a general anaesthetic. I understand Young Veterinary Partnership will make reasonable attempts at contact before pricing changes but will always act in my pets best interests. I understand that all accounts are payable at the time of patient discharge.
• I understand that all dental procedures are limited to two hour procedures, for patient safety reasons. I understand if my pet requires numerous extractions a further dental procedure may be required and will be charged at a 25% reduced fee if performed within 6 months to the consented procedure above.

I give permission for Young Veterinary Partnership to take photos or videos for educational and / or marketing purposes.