(317) 721-7387
Email Us
10598 N College Ave #200 Carmel, IN 46280



(317) 721-7387

Request An Appointment

Home
About
Services
Resources
Emergency Veterinary
Join Our Team
Contact
Book Appointment

We are pleased to offer services to our Spanish-speaking clients. Nos complace ofrecer servicios a nuestros clientes de habla hispana. Llame ahora!

Anesthesia Consent Form

Save time during your next appointment. Complete your anesthesia consent form online from any device at any time before your visit.

Anesthesia Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pets before your visit.

Pet Information

Pet's Name *

Contact Information

Owner's Name *

First

Last

Email *

Phone *

Additional Number

Secondary Contact: *

First

Last

* This person has your authority to consent to medical decisions regarding your pet's surgical care in the event we cannot reach you.

Secondary Contact Phone *

Today's procedure is: (example: lump removal, exam, etc.) *

Additional Services Desired While Patient Is Sedated

Please select any/all that you would like us to provide while your pet is sedated

Implant Microchip
Nail Trim
Clean Ears
Express Anal Glands
Sanitary Clip (rectum, genitals)
Remove Lumps (specify location of lumps below)
Other (specify below)

Please specify where the lumps are located *

Please specify the additional service(s) you'd like provided to your pet *

Authorization

I authorize anesthesia/sedation for my pet. The nature and risks of this procedure have been explained to me. I understand some risks always exist with anesthesia and/or sedation, and I am encouraged to discuss any concerns I have about those risks with my veterinarian before the procedure(s) are initiated. My signature on this consent form indicates that any questions have been answered to my satisfaction. *

I have read, understand, and authorize

I authorize Leo's Pet Care to perform any additional diagnostic, treatment, or surgical procedures deemed necessary for medical complications or otherwise unforseen circumstances. I understand there are rare complications associated with any anesthetic procedure. No warranty or guarantee has been given to me as to the results or cure afforded by these treatments or procedures. I fully understand these risks and understand the veterinarians and hospital staff will try to minimize such risks. I will not hold Leo's Pet Care, the veterinarians, or any staff member liable for any complications that may arise. *

I have read, understand, and authorize

Payment due upon services rendered. *

I have read, understand, and agree

I have read and fully understand this anesthesia consent form *

Yes

Signature of Responsible Party *

Clear Signature

Date *

Ready To Visit!

We proudly serve the pets of Carmel, Indianapolis, Broadripple, Nora, Westfield, Zionsville, and beyond. We look forward to seeing you and your pet! Book an appointment by clicking on the button below.

Book Appointment

Questions?

Get in touch! We look forward to hearing from you.



Location

10598 N College Ave #200
Carmel, IN 46280



Contact Information

Phone: (317) 721-7387
Email: info@leospetcare.com



Hours

Monday – Friday: 8:00am – 6:00pm
Closed Weekends

Name *

First

Last

Email *

Phone

How can we help you? *

Comment

© 2024 Leo's Pet Care | Powered by WhiskerCloud | Privacy Policy | Accessibility Statement