Surgery Consent Form

Name: Barta Animal Hospital
Address: 4045A CR 3900, Independence, KS, 67301, United States
Telephone: 620-331-6327
Price range: $

Get Started

Surgery Consent Form

Thank you for giving us the opportunity to care for your pet. We’ll be happy to answer any questions you have about your pet’s health. To ensure the best care possible, please take the time to fill in this form completely.

Owner's Name *

First

Last

Phone *

Email *

Pet's Name *

Surgical Procedure: *

Ovariohysterectomy/Spay (Female)
Castration/Neuter (Male)
Dental Scaling/Polishing/Extractions
Onychectomy (Declaw)
Abscess/Laceration
Orthopedic
Other

If 'Other', please specify: *

**Recommended: Laser Treatment ($9.75) – promotes healing-post surgery *

I would like my pet to receive laser treatment.
I would not like my pet to receive laser treatment.

Pain Management: Surgical analgesics (painkillers) provide comfort, reduce stress and allow for a smooth recovery from surgery. *

I authorize
I decline

If antibiotics are required, which would you prefer: *

Liquid
Tablet

As with any surgery requiring general anesthesia, certain risks may result in serious complications or even death. To minimize such risks, we offer the following pre-surgical testing.

We recommend pre-anesthetic blood screening for all pets with general anesthesia. A pre-anesthetic blood chemistry screen will reduce the risk of anesthesia by detecting problems with the liver and kidneys. These two major internal organs (in addition to the lungs) are responsible for eliminating most of the anesthetics from the body. Although most patients have optimally functioning livers and kidneys, it is those few pets that do have an underlying &/or hidden problem(s) and shouldn’t have anesthesia at this time that we want to screen for. Our goal at Barta Animal Hospital is to make this surgical procedure as safe as possible for your pet. The charge for the blood screening is $86.25. *

I authorize
I decline

I agree to allow the medical staff at Barta Animal Hospital to perform surgery on my pet. I have been informed of and understand the surgical procedures and risks. *

I have read and agree.

Signature *

Date *

Method of Payment *

Cash
Check
MasterCard
Visa
Discover
CareCredit

Request an Appointment

Schedule an appointment online or call us today at 620-331-6327.

APPOINTMENT

Questions?

Feel free to contact us.



Contact Information

Phone: 620-331-6327
Email: [email protected]

}

Hours

Monday - Friday: 7:30 AM - 5:30 PM
Saturday: 8 AM - 12 PM
Sunday: Closed



Location

4045A CR 3900
Independence, KS 67301

We proudly serve the animals of Independence, KS, and beyond.

Please fill out the contact form below to get in touch with us.

Name *

First

Last

Email *

Phone

How can we help you? *

Website