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.