Classic form

Vet surgery consent form with bloods, fluids and estimate

A vet surgery consent form has to record what the owner agreed to: the procedure, the optional anaesthetic extras, the estimated cost and what to do if something goes wrong. This one asks each of those as its own question, including resuscitation, and keeps a contact number for the day above the owner signature.

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Top of the vet surgery consent form with bloods, fluids and estimate example
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Surgery and anaesthetic consent

Marrowbank Veterinary Clinic. Please complete this before admission on the morning of surgery. Your pet should have had no food after 10 pm last night, but water is fine until you leave home.

Owner and pet

Anaesthetic choices

A blood test before the anaesthetic checks the liver and kidneys, which clear the anaesthetic drugs. Fluids through a drip support blood pressure while your pet is asleep. Both are recommended for pets over seven years old.

Cost and wishes

I am the owner, or authorised by the owner, and I consent to the procedure and anaesthetic above. I understand every anaesthetic carries a small risk.

Every field, and what it collects

The complete field list, in the order respondents meet it.

Owner and pet

Owner nameNameRequired
Pet name and speciesShort textRequired
ProcedureDropdownRequired
Options: Desexing, female · Desexing, male · Dental scale, polish and any extractions · Lump removal · Wound repair · Cruciate ligament repair · Other, as discussed with the vet

Anaesthetic choices

Pre anaesthetic blood testSingle choiceRequired
Options: Yes, run the blood test before the anaesthetic · No, go ahead without it
IV fluids during the anaestheticSingle choiceRequired
Options: Yes, give fluids through a drip · No fluids

Cost and wishes

Estimate total from your written quote, in dollarsNumberRequired
The estimateMultiple choiceRequired
Options: I understand the estimate may change, and the vet will call me before going over it
If your pet's heart or breathing stops under anaestheticSingle choiceRequired
Options: Attempt resuscitation · Do not attempt resuscitation
Number to reach you todayShort textRequired
Owner signatureSignatureRequired

What each field on this form collects

Owner name sits beside pet name and species. The procedure dropdown lists seven, from desexing to cruciate repair, with an other choice for anything discussed with the vet. A paragraph explains what the blood test and drip do, then two radios record yes or no for each. The estimate total is a number copied from the written quote, and a single tick acknowledges it may change with a call first. Resuscitation is a radio of two. A number to reach the owner today is required, then a consent paragraph and the owner signature close the form. All ten fields are required.

Why the extras are separate questions

Pre anaesthetic blood tests and IV fluids are the two add ons owners most often ask about at the desk, because they add to the bill. As separate radios, each one is a decision the owner makes after reading why it helps, not a line hidden in the estimate. The paragraph says both are recommended for pets over seven, which gives a fair reason without pressure. If the owner says no and something goes wrong, the response shows the choice was offered and explained.

What professional guidance asks for

The Royal College of Veterinary Surgeons says informed consent means the client understands the procedure, the risks, the options and the likely cost, and that the estimate should be updated if costs change. The American Veterinary Medical Association sets out the same expectations for clear client communication. Resuscitation wishes are asked in advance because there is no time to call during an arrest. Writing the estimate total into the response gives the clinic a record if the final bill is disputed.

How to adapt this form

A cat only clinic replaces the procedure list with feline procedures and adds a question about the indoor or outdoor recovery plan. An emergency hospital removes the estimate number, since it is given verbally, and adds a deposit tick. A clinic that does dental work most days adds an extraction limit, for example call me before removing more than two teeth.

What makes this form work

Bloods and fluids explained, then asked

One paragraph explains both extras, then two radios ask each separately. Owners decide with the reason in front of them.

The estimate is recorded as a figure

The number field holds the total from the written quote, so the agreed cost is in the response beside the signature.

A phone number for today only

The required field asks for a number to reach the owner today. The vet calls it if the plan or the estimate changes during surgery.

Questions people ask

Why does a vet surgery consent form ask about resuscitation?

Because if a pet's heart stops under anaesthetic, the team has seconds to act and cannot wait for a phone call. Most owners choose resuscitation, but owners of very old or very ill pets sometimes do not. Asking before admission means the vet knows the owner's wish if it is ever needed.

Is a pre anaesthetic blood test really needed?

It is optional, which is why it is a choice. It checks the organs that clear anaesthetic drugs and can find a problem that changes the plan. Vets recommend it more strongly for older pets, and the paragraph says over seven. A young healthy pet is often fine without it.

Why enter the estimate as a number?

A number in the response is a clear record of what the owner saw before surgery. If the final bill is higher, the clinic and the owner can compare it with the agreed figure and the call that came in between. The form does not calculate anything; it records the total from the written quote.

What happens if the vet finds something unexpected during surgery?

The estimate tick says the vet calls before going over it, and the thank-you screen tells owners to keep their phone on. That is why the number for today is required. A clinic that wants a rule for when the owner cannot be reached can add a radio for that case.

Can someone other than the owner sign?

The consent paragraph says the signer is the owner or authorised by the owner, which covers a partner or a pet sitter dropping the animal off. The clinic should still have the owner's details on file. For costly surgery, many clinics prefer the owner to sign, and the paragraph can be tightened to say so.

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Sources

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