Phone: (775) 853-6900

     

6474 Bonde Ln, Reno, NV 89511

Menu
  • Home
  • About Us
    • Our Values
    • Vision Statement
    • Doctors
    • Nutritional Counselor
    • Licensed Veterinary Technicians
    • Client Care Specialists
    • Patient Care Specialists
    • Pet Resort – Daycare & Boarding
    • Grooming
    • Hospital Administration
  • General Services
    • Preventative Health Care
    • Vaccines and Antibody Titers
    • Preventative Non-Anesthetized Teeth Cleanings and Assessments (PTCA)
    • Dental Surgeries
    • Sick Pet / Emergencies
    • Soft Tissue and Orthopedic Surgery
    • Platelet-Rich Plasma (PRP) Therapy
    • Pet Insurance
    • End of Life Care
    • Veterinary Resources
  • Holistic Services
    • What is Integrative Medicine?
    • What to Expect on Your Visit
    • Holistic Fee Schedule
    • Acupuncture
    • Gold Bead Therapy
    • Fecal Transplant
    • Chiropractic/Orthopedic Manipulation
    • Therapy Laser / Photobiomodulation
    • Ozone
    • Prolozone Therapy
    • Chinese Herbal Therapy
    • Massage Therapy
    • Vaccines and Antibody Titers
  • Client Forms
  • For Vets
    • What to Expect for Your Patient
    • When to Refer
    • Referral Form
  • Blog
    • Acupunture
    • Ozone Therapy
    • Chiropractic
    • Orthopedic Manipulation
    • Laser Therapy
    • Chinese Herbal Therapy
    • Photobiomodulation
    • Massage
    • Team Member Of The Week
    • Misc
  • Contact
    • PetDesk
    • How Did We Do?
    • Application For Employment
  • Shop Online

Mountain View Animal Hospital & Holistic Pet Care

Ultrasound Consent Form


  • Date Format: MM slash DD slash YYYY
  • Thank you for entrusting Mountain View Animal Hospital and Holistic Pet Care to perform a diagnostic ultrasound. Ultrasonography is a non-invasive technique to image organs within the abdomen or chest. The area to be imaged must be shaved in order to provide adequate imaging, and minor irritation may occur to the skin as a consequence. Hair regrowth generally takes multiple weeks to occur, but can be more prolonged in certain pets.

    The ultrasound is performed by a third party certified ultrasound technician. A nurse or assistant will phone when the testing is complete and will discharge your pet. The technician can not legally provide any medical findings. Further, the results typically are not available on the same day as the ultrasound. The images are sent to a board certified ultrasound radiologist and/or cardiologist for review. Your primary veterinarian will be contacting you with results and treatment plan once the results from the radiologist are completed. The results take 2-4 business days unless they were sent STAT for an additional charge because of an emergency situation. The ultrasonographer technician is not available for consultation with clients.

    If indicated, fine needle aspiration is a procedure involving placement of a needle, using the guidance of an ultrasound, into an organ or mass. A sample of tissue cells is drawn into the needle, placed on a slide, and sent in to a diagnostic laboratory to look for cancer cells, inflammation or other abnormalities. This procedure is often recommended if an abnormality is identified on ultrasound, and is the first step towards diagnosing the nature of the abnormality. Some problems are easily diagnosed via fine needle aspiration but others may not yield an answer via this technique. Fine needle aspiration is generally a safe procedure, but there is a small risk of significant bleeding from the organ or mass targeted. The risk is increased in patients that have a bleeding disorder and in certain cancerous masses, but may also rarely occur in patients that were not considered to be at risk, and may require intervention to stop or risk serious health complications. Fine needle aspirations would be performed by the attending doctor. Possible blood work to assess bleeding concerns is always recommended and can be performed the same day, prior to any aspirations at an additional cost.

    Light sedation is typically necessary to perform the ultrasound, fine needle aspirations, and other diagnostic tests to receive accurate results and the clearest images, as even light panting can cause distorted images that may result in misinterpretation. Sedation usually only last a few hours, but some patients that are more sensitive can remain quiet until the following day. Rarely, depending on the type of sedation used, there may be a detrimental impact on blood pressure, heart rate, or breathing that could require intervention or risk serious health consequences. General anesthesia is usually never necessary.   

  • Please initial if giving consent:

    I consent to have an ultrasound performed on my pet by the certified ultrasound technician.

  • I have signed/will sign the sedation consent form prior to my pet being admitted to the hospital.

  • I consent to have fine needle aspirations performed on my pet if deemed indicated by results of the ultrasound and accept additional costs. If aspiration is performed, a coagulation blood test (PT/PTT) will be performed prior at an additional cost. (if initially declined, a repeat visit *with a possible recheck ultrasound fee* can be scheduled)

  • Authorization for Sedation

    I have elected conscious sedation for your pet's procedure today. This sedation will be "light conscious sedation" where my pet will maintain protective reflexes, however, they will be less aware of their environment. I certify that I am the owner, or authorized agent of the owner, of the animal above and have full authority to execute this agreement. I also certify that I am 18 years of age or older. I authorize Mountain View Animal Hospital and Holistic Pet Care (MVAH & HPC), its veterinarians and employees under veterinary supervision, to perform the procedure(s) identified above. I understand that some risk always exists with sedative administration and invasive procedures and that during performance of these/this procedure(s), conditions may be encountered that necessitate an extension of, or variance from, the procedure(s) set forth above. I have discussed the recommended procedure(s), associated risks and anticipated recovery with an attending veterinarian. All questions and concerns I have about sedation, procedures and associated risks have been answered to my satisfaction. I understand that a reasonable attempt will be made to contact me if expected fees will exceed the estimate by 15% or more. I agree to assume financial responsibility for all fees associated with the care of my pet and agree to provide payment in full, in accordance with the payment policy, at the time my pet is discharged. This consent will cover the next 12 months for any elective sedation procedures. I will notify the doctor if there are any changes in my pets health since the last sedation procedure.

    CPR CONSENT AND RELEASE OF LEGAL LIABILITY

    Based on the medical judgement of MVAH & HPC's veterinarian(s), should my pet require CPR, including cardiac compression, positive pressure respiration, emergency drugs, or other interventions, I request or decline that the doctor(s) at MVAH & HPC pursue such medical care as indicated below. Furthermore, I have been informed by the team at MVAH & HPC that less than 5% of animals that require CPR will survive to be discharged from the hospital. I understand that despite the best efforts of the veterinarians and the team members at MVAH & HPC, CPR may not allow my pet to regain his/her normal mental or physical capacity. Priced from $75-$150, charges are due in full upon pick up if CPR is performed. Regardless of whether I consent or decline to have CPR performed on my pet, in consideration for following my directive, I hereby waive, release and discharge any and all claims for damages, including, but not limited to, claims for death, injury or property damage, whether or not resulting from the negligence, gross negligence or other acts of MVAH & HPC, its veterinarians and staff. I declare that any such veterinarian, staff, and MVAH & HPC is acting in accordance with my directions. This is intended to be an advance release of legal liability.

  • Fill out what procedure you would like.
  • I, the authorized owner, have read and understand everything stated above. I understand the results, unless an emergency and sent to the radiologist with an additional STAT fee, the results may take 2-4 business days to return. The attending doctor will call my primary phone number on file when received. I understand payment is required in full at time of discharge.

  • Date Format: MM slash DD slash YYYY
  • Mountain View Animal Hospital and Holistic Pet Care

    6474 Bonde Lane Reno, NV 89511

    775-853-6900 (phone); 775-853-6966 (fax)

Sitemap | Website by DOCTOR Multimedia
Accessibility
Font Resize
Contrast
Accessibility by WAH
  • Accessibility
  • Application For Employment
  • Blog
  • COVID-19 Update
  • Events
  • Grooming
  • Holistic Pet Care in Reno, NV
  • Home
  • How Did We Do?
  • Licensed Veterinary Technicians
  • My Calendar
  • Our Values
  • Parasite Prevention
  • Patient Information Form
  • Pet Desk
  • Pet Grooming In Reno, NV
  • Pet Resort in Reno, NV
  • Review Us
  • Reviews
  • Sitemap
  • Thank You
  • Thank you
  • Veterinary Resources
  • Veterinary Services in Reno, NV
  • What Can We Improve
  • What is Integrative Medicine?
  • About Us
    • Vision Statement
    • Doctors
    • Client Care Specialists
    • Nutritional Counselor
    • Patient Care Specialists
    • Pet Resort – Daycare & Boarding
    • Hospital Administration
  • New Clients
    • Pet Insurance
    • Online Forms
  • Services
    • Daycare and Boarding
    • Pet Wellness Program
    • Preventative Health Care
    • Vaccines and Antibody Titers
    • Preventative Non-Anesthetized Teeth Cleanings and Assessments (PTCA)
    • Dental Surgeries
    • Sick Pet / Emergencies
    • Soft Tissue and Orthopedic Surgery
    • Platelet-Rich Plasma (PRP) Therapy
    • End of Life Care
  • Contact
  • Appointments
  • Holistic Services
    • Fecal Transplant
    • Gold Bead Therapy
    • Holistic Fee Schedule
    • Acupuncture
    • Chiropractic/Orthopedic Manipulation
    • Chinese Herbal Therapy
    • Equine Chiropractic
    • Prolozone Therapy
    • Preventative Oral Exam & Cleaning
    • Gold Bead Therapy
    • Ozone
    • What to Expect on Your Visit
    • Therapy Laser / Photobiomodulation
    • Massage Therapy
  • Client Forms
    • New Client Form
    • Preventative Teeth Cleaning & Oral Agreement Form
    • Boarding and Daycare Agreement Form
    • Animal Dental Care Consent Form
    • Ultrasound Consent Form
    • Sedation Consent Form
    • Drop Off Form
    • Holistic Pet Care New Patient Form
    • Urgent Care Appointment & Client Consent Form
  • For Vets
    • Referral Form
    • When to Refer
    • What to Expect for Your Patient