Surgery Consent Form

Thank you for choosing Crossroads Animal Hospital. Please fill out the following form before your scheduled appointment with us. We look forward to seeing you and your pet!

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Surgery Consent Form

To better treat your pet, please fill out the following form as thoroughly as possible before your appointment with us. If you have any questions, please feel free to call us at 225-261-6000.

Our Doctors recommend doing all of the "optional" pre-anesthesia testing. These tests are important to have a good baseline on file for any future illnesses and to catch any current abnormalities.
ECG checks the electrical impulses of the heart. This is submitted and then checked by a cardiologist who gives a report by email and recommends or verifies anesthesia being used. $91.
* Radiographs(x-rays) show internally the condition of the heart and lungs. $121 a 50% discount.

Total: $212

* Urinalysis add-on to screen for urinary tract infections and other diseases, and to evaluate the kidney's ability to concentrate urine and filter anesthetic agents from the bloodstream. $87 a 50% discount.

Total with Urinalysis: $299

While undergoing these procedures your pet will receive anesthetic drugs that prevent pain. Because we care about your pet’s comfort and strongly believe that pain relief is important, additional pain medications will be provided, as needed, to control the level of your pet’s discomfort after surgery and during its recovery.
* A Capstar will be given to your pet to ensure and to control fleas, unless your pet is on Bravecto, Nexgard, or Simparica. If your pet is excessively soiled, a bath will be given prior to surgery at an additional expense to ensure a clean surgical site. Longer and/or matted hair will be an additional $5.00 to $10.00 charge.

* During dental procedures, it may be necessary for extractions and/or antibiotics. These are additional charges.

I understand that during the performance of the foregoing procedure(s) or operation(s), unforeseen conditions may be revealed that necessitate an extension of the foregoing procedure(s) or operation(s) or different procedure(s) or operation(s) as are necessary and desirable in the exercise of the Veterinarian's professional judgment.

I also authorize the use of appropriate anesthetics and other medications, and I also understand that hospital support personnel will be employed as deemed necessary by the Veterinarian.

I have been advised as to the nature of procedures or operations and the risks involved. I realize that results cannot be guaranteed and that the doctor nor the clinic can not be held liable in the event of some unforeseen incident.

I have read and understood this authorization and consent. I further understand that I assume financial responsibility for all services rendered.
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