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Surgery Release Form

  • Please complete the following questions:

  • Owner Release

    For the enhanced protection of our patients we recommend a Pre-Surgical Blood Screen of all pets prior to the administration of anesthetics. I understand that there is an additional charge for this and if I refuse this service I am therefore responsible for any risks or complications that may arise from the surgical procedure being performed today. The cost of the Pre-Surgical Blood Screen is an additional $ 55.00. (PLEASE INITIAL ACCEPT OR DECLINE)
  • The Pre-surgical Blood Screening for my pet prior to anesthesia today.
  • The Pre-surgical Blood Screening for my pet prior to anesthesia today.
  • I understand that Dr. King and/or Dr. Hartman and the staff at Valley View Veterinary Hospital will use all reasonable precautions against injury, escape, or death of my pet. I understand that anesthesia and surgery always involve some risk to my pet and I agree that Dr. King and/or Dr. Hartman and her staff will not be held responsible in connection to these procedures. In the event complications arise and I cannot be immediately contacted at the phone number listed above, I give full consent to Dr. King and/or Dr. Hartman and her staff to perform whatever actions reasonable, necessary, and in the best interest of my pet. I have read and agree to the above information.