Sedation Consent Form to Print

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​Patient Name:  _______________________ 

Client Name:   ________________________      
 


I hereby certify that I am the owner of the above-named animal or am responsible for it and have the authority to execute this consent.
 
I hereby authorize the performance of the following procedure(s):

1) 
2)
3)
 
I hereby also authorize the use of such anesthetics as you deem advisable and performance of such surgical or therapeutic procedures as you determine to be indicated.
 
I agree to indemnify and hold Mountain View Veterinary Hospital harmless from and against any and all liability arising out of the performance of any of the procedures referred to above.
  
Number to be reached at today:  _____________________________________ 

Signature: _______________________________________________________