Thorpe Animal Hospital

396 Lake Nepessing Rd
Lapeer, MI 48446


Authorization for Anesthesia and/or Surgery


Please read carefully and sign.

I, the undersigned owner or agent of the owner of the pet identified above, authorize the veterinarian(s) and staff at Thorpe Animal Hospital to perform the above procedure(s). I understand that some risks always exist with anesthesia and surgery and that I'm encouraged to discuss any concerns I have about those risks with the attending Veterinarian before the procedure(s) is/are initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:

The reasonable medical and/or surgical treatment options for my pet
Sufficient details of the procedures to understand what will be performed
How fully my pet will recover and how long it will take
The most common and serious complications
The length and type of follow up care required
The estimate of the fees for all services provided including additional fees related to being in heat or pregnant at the time of surgery.
I agree to pay a deposit if required

We recommend a blood profile and other possible diagnostic testing before anesthesia and surgery to ensure that your pet is in a low-risk category. The latest technology lets us run safe, accurate blood chemistries minutes before anesthetic induction. These tests are similar to those your own physician would run were you to undergo anesthesia. In addition, the results of these tests will serve as reference values for future use should your pet become ill. Please see the options within the attached estimate to determine which tests apply for your pet.

While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved. I agree to assume financial responsibility and provide payment via cash, credit card, or check. I have read fully and understand the terms and conditions set forth above.

Surgery Consent Form

If we see fleas or evidence of fleas on your pet, we will treat your pet with appropriate product at an additional cost to you. Please Initial

Signature of owner or authorized agent
First Name
Last Name
Date :
Phone TypePhone Number


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