Surgical Consent

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Get Started

Surgical Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit. If this is an emergency, or if your pet needs urgent care, please call us at 734-475-8696 for a faster response.

In case of an emergency
If applicable

The nature of such service has been described to me to my satisfaction and I realize that no guarantee or warranty can ethically or professionally be made regarding the cure or result. I further recognize that there is an inherent risk of adverse reaction to any medication, including anesthetics, and vaccinations that may be administered to my pet.

I understand that I assume financial responsibility for all services rendered, and that payment is due at the time the animal is released. A finance charge of 1.5% per month will be computed on all unpaid balances over 30 days. A fee of 33-1/3% will be assessed to all accounts that require outside collection services.


Your signature below constitutes your acknowledgment that (i) you have read and agreed to the above, (ii) the procedure(s) have been explained to your satisfaction and that you have all the information that you desire, (iii) you have had the chance to ask questions, and (iv) you authorize and consent to the performance of the procedure(s) and to the administration of anesthesia.

Sign here