E-Collar Consent:
It is hospital policy that all pets with an incision are discharged with an e-collar to protect the pet from chewing or licking the surgical site. Serious complications (i.e. dehiscence) may arise if a pet licks or chews apart an incision. We are able to provide your pet with an e-collar upon discharge and it will be yours to keep.
Post-Surgical Consent:
We would like to inform you that there may be some degree of pain involved in this surgical procedure. We recommend that your pet receive an injection for the pain.
YES, I want my pet medicated for post-surgical pain. The cost is $34.95 to $38.95 depending on the animal’s weight.
YES, I want my DOG to receive pain medication for home. The cost is $16.95 to $24.95 depending on the DOG’S weight.
YES, I want my CAT to receive pain medication for home. The cost is $9.95 to $19.95 depending on the need for home meds as determined by the veterinarian. Kidney enzymes may be required to check at $19.95.
NO, I decline this service for my pet.
In Case of Emergency
Emergency telephone number where I may be reached:
I authorize the doctor, his/her agents or staff in an emergency situation to follow through with such procedures as are necessary for the well being of my pet on a continuing basis regardless of the additional cost which I understand cannot be estimated or calculated at this time. I understand that I assume all financial responsibility for all services rendered and for the cost of any inventory utilized during this emergency procedure.
I DECLINE any emergency treatment if complications develop during the above procedure.
It is understood that if any estimate is given to the owner/agent by the doctor, his/her agents, servants, and/or representatives to the owner/agent of owner that this is only an estimated price for the service rendered. It is understood that there may be unforeseen complications and that further treatment may be necessary for your pet during or following the above described surgical procedure.
The owner/agent of owner acknowledges, accepts and assumes full and total financial responsibility for any and all services rendered by Memphis Animal Clinic, its staff or employees in the treatment of the above described animal and to pay for such services when the services are performed or when the animal is picked up.
