Ortho Consent in Tulsa, Oklahoma - Woodland West Animal Hospital

Name*

First Last

Phone*

Would you like surgical updates via text?:*

Yes
No

Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Pet's Name*

I authorize the doctors and staff of Woodland West Animal Hospital to perform the following procedures on my pet.*

Reason for sedation

Consent

I consent to the surgery form with knowledge of the below statements.

I understand the following for my pet:
1) My pet will have one or more limbs shaved for a catheter placement and the limb on which the surgery will be performed will be extensively or fully shaved for the procedure.

2) My pet will have to be under strict activity restrictions for 8-12 weeks.

3) My pet will have rechecks following discharge from the hospital. There will be no charge for the recheck exams or radiographs.

4) My pet may require sedation for recheck radiographs to assess healing. I understand I will be financially responsible for the cost of the sedation medications.

5) Complications with orthopedic implants include, but are not limited to, infection which may require further surgical procedures.

6) Orthopedic implants may fail which may require revision of the surgery and additional costs. Sometimes a revision surgery is not possible requiring the limb to be amputated.

7) My pet will have to stay one or more nights following surgery to adequately manage post-operative pain.

***My Pet Has Fasted Since 12 AM Midnight***

My pet’s procedure, its estimated cost, and possible complications have been fully explained to me.
I understand the risks associated with general anesthesia and that this may include death.

Client Signature (Please Type Your Name to Sign). By clicking submit I acknowledge that my pet's procedure and its possible complications have been fully explained to me. I understand the risks associated with general anesthesia and that this may include death.*

Please type your name to sign

Ortho Surgical Consent