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Pre Anesthetic Consent Form Mah

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Pre-Anesthetic Consent Form - MAH

Pre-Anesthetic Form - Veterinary

Page 1

Please complete this form prior to your pet's anesthetic procedure.

Email*

Pet's Name*

Breed*

Age*

Weight*

Date of Procedure*

Select date

Type of Procedure*

Pre-Anesthetic Bloodwork

CBC

Chemistry Panel

Other

Pre-Anesthetic ECG

Yes

10.

Additional Comments

Description:This pre-anesthetic consent form is designed for veterinary clinics to obtain consent from pet owners before administering anesthesia to their pets. It includes important information about the risks and benefits of anesthesia, as well as instructions for preparing the pet for the procedure. By signing this form, pet owners acknowledge that they have been informed about the procedure and give their consent for their pet to undergo anesthesia.

Are you a veterinary clinic looking for a pre-anesthetic consent form to use for your patients? Look no further than this customizable template. This form includes all the necessary information to obtain informed consent from pet owners before administering anesthesia to their pets. It covers important topics such as the risks and benefits of anesthesia, as well as instructions for preparing the pet for the procedure. By using this form, you can ensure that pet owners are fully informed about the procedure and have given their consent for their pet to undergo anesthesia. Customize this form to meet the specific needs of your clinic and start using it today.

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Address*

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Date of Birth*

Address*

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Introduction*

Consent to Telehealth Services*

I understand that telehealth services involve the use of electronic communications to enable healthcare providers to diagnose and treat me from a remote location.

I understand that telehealth services may not be as complete as face-to-face services.

I understand that I have the right to withhold or withdraw my consent to the use of telehealth services at any time.

I understand that there are potential risks associated with the use of telehealth services, including but not limited to technical difficulties, unauthorized access, and interruptions in service.

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