Thank you for taking the time to pre submit the Dental Consent Form before your pets dental appointment.
Owner / Agent For Owner (required)
Your Email (required)
Weight (in pounds):
Your pet has been scheduled for a Dental Prophylaxis (teeth cleaning) for today. The need for extractions is always a possibility since we are unable to probe the mouth/teeth for problem areas while your pet is awake. Dental extractions, minor surgery, of dental x-rays may be warranted after a through exam of the mouth/teeth once your pet is anesthetized. Therefore it is imperative that we are able to contact you, if we need to, while your pet is anesthetized.
I am the owner or agent of the animal listed above. I have the authority to
execute this consent and I am over the age of 18 years. I hereby authorize and direct the veterinarians of Abby Pet Hospital to perform the above described procedure(s). The nature and purpose of the procedure(s) has been explained to me and I understand that no guarantee exists as to the result of diagnoses and treatment of the said animal. I have had the fees outlined to me and agree to pay in full for all services rendered, including those deemed necessary for medical or surgical complications or for any unforeseen circumstances. I agree to pay in full for all services rendered at the time of discharge. If unforeseen conditions arise, I authorize the attending veterinarian to do what is in the best interest of my pet's health.
I agree that I have read and understand this consent form