Surgical Consent Form

Surgical Consent Form – Fanwood Animal Hospital

At Fanwood Animal Hospital in Fanwood, NJ, your pet’s safety is our top priority. If your pet is scheduled for surgery, please complete our Surgical Consent Form prior to their procedure.

A black and white dog with a cone on its head

Preparing for Your Pet’s Surgery

This form allows us to:

Review important details about your pet’s health.
Confirm your authorization for the procedure.
Ensure we have the information needed to keep your pet safe and comfortable before, during, and after surgery.

How to Complete the Form



Please fill out and submit this form at least 24 hours before your pet’s scheduled surgery. Our team will confirm the details with you and answer any questions you may have.

For urgent medical needs, call us immediately at 908-955-0693.

Client Name *

Email *

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Pet's Name *

Species *

Cat
Dog

Breed *

Sex *

Male
Female

Color *

Markings *

Birthdate

Pets must be current on vaccinations and tested according to the hospital policy. *

Yes

I am the owner or agent for the owner for the described animal and have the authority to execute consent and hereby authorize the following surgery *

Yes

Type of Surgery

I understand that during the performance of these procedures, unforeseen circumstances may arise that may necessitate an extension of the above procedures. I authorize such procedures to be performed as necessary in the professional judgement of the veterinarian & agree to pay for services rendered. The nature of the procedures has been described to my satisfaction, and I realize that no guarantee or warranty can ethically or professionally be made regarding the results or cure. I understand that I assume financial responsibility for all services rendered and that payment is due at the time the animal is released. Please be aware that all surgeries require an ECG and pre-operative blood work to ensure the well-being of your pet. Please consider having the Fi Nano microchip implanted while your pet is here today. This will assist in your pet being returned to you if they ever become lost. The cost will be $65 with free registration.

Yes
No

Emergency Phone *

Signature *

Clear Signature

$25 OFF for New Clients!*

Surgical Consent Form

Preparing for Your Pet’s Surgery

How to Complete the Form

Schedule Your Pet’s Visit Today

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Contact Information

Address

Hours