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Dental and Anesthesia Consent Form

Dental and Anesthesia Consent Form at Countryside Animal Hospital

Understand and acknowledge that the veterinarians at Countryside Animal Hospital will perform a dental and administer anesthesia as deemed necessary. I understand that some risks always exist with anesthesia and/or dental surgery, and I am encouraged to discuss any concerns I have about those risks with my veterinarian before the procedure(s) are initiated. My signature below is consent to the dental and anesthesia administration.

Risks and Complications:
I am aware that dental surgery and anesthesia carry inherent risks, including but not limited to infection, adverse reactions to medications, bleeding, and the possibility of unforeseen complications.

Pre-Anesthetic Assessment:

Dental X-Rays:

Emergency Procedures:
I authorize the veterinarian to perform emergency procedures or administer additional treatments that may become necessary during the course of the dental. I understand that efforts will be made to contact me in such situations, but if unreachable, I trust the veterinarian's judgment in the best interest of my pet.

Clear Signature