Surgery Consent Form

Please fill out this form prior to your visit.

I, the undersigned owner or agent of the owner of the pet identified above, certify that I am eighteen years of age or over and authorize the veterinarian(s) at The Pet Hospital of Tierrasanta to perform the above procedures(s). I understand that some risks always exist with anesthesia and/or surgery, including allergic reactions, heart problems and death. I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:

  • The reasonable medical and/or surgical treatment options for my pet
  • Sufficient details of the procedures to understand what will be performed
  • How fully my pet will recover and how long it will take
  • The most common and serious complications
  • The length and type of follow-up care and home restraint required
  • The estimate of the fees for all services
  • Any necessary payment arrangements.
Please list the percentage of the estimated fees you agree to pay as a deposit.
Clear Signature

Get In Touch

We've proudly served the pets of Ithaca, NY for over 30 years.

Your pets are as important to us as they are to you, and we strive to demonstrate that in all that we do. Your dog or cat deserves the best veterinary care.

Contact Info

Phone: 607-273-3133
Fax: 607-238-2363
Email: email@ithacavet.com

Address

712 W Court St.
Ithaca, NY 14850
Click here for directions.

Hours

Mon, Tues, Thurs, Fri: 7:30 am - 6 pm
Wed:7:30 am - 7:30 pm
Sat: 8 am - 12 pm
Sun: Closed

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