SALEM VETERINARY HOSPITAL
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    Surgery Consent Form



           I authorize Barbara Sheffield, DVM and her agents, to receive and provide care for my pet listed above.  I understand that all precautions will be taken to ensure the safety  and good health of my pet during its stay and if any concurrent problems develop with my pet, treatment as deemed necessary by  the doctor will be provided.  I will assume full responsibility for the treatment expense involved.  
           To prevent contracting and the spread of infectious diseases and parasites, all animals received must be current on all vaccinations and free of internal and/or external parasites deemed necessary by the doctors at the Salem Veterinary Hospital.  I authorize the doctor to provide vaccines and parasite control as needed for my pet. ​
          * Your pet will be undergoing sedation and/or general anesthesia plus a surgical or diagnostic procedure today.  In order to recognize any underlying abnormalities your pet may have, we perform a pre-surgical blood profile on your animal.  This consists of a PCV/TS, which will check blood volume, and an ALT, ALKP, CREA, GLU, TP, and BUN, which will check blood glucose, kidney function and liver values.  A more comprehensive blood panel as well as other tests may be necessary if your pet is injured, ill, or older. 
          * These blood tests will help us to assess the health status of your pet more completely and determine if there are any additional precautions we need to take prior to surgery.  
          *  I understand that all anesthesia involves some risk to my pet including (rarely) death and unforeseen complications such as infection, bleeding, or herniation with certain surgeries.  I am aware that many, but not all, pre-existing conditions can be identified prior to surgery by performing these in-house tests. 
         *We recommend presurgical electrocardiograms to evaluate for possible heart anomalies that may not be discerned during auscultation alone. There is an additional charge for these tests.  
     Advanced Surgical Monitoring is required on all pets over 8 years of age.​

      I have read all of the above and understand and accept the risks involved.  I also understand that payment is due at the time  services are  rendered.
    Please print out a copy of this form before clicking "submit", and be sure to bring the form with you to your scheduled appointment.
Submit
HELPFUL INFORMATION

Office Hours

Monday:  8AM – 6PM
Tuesday:  8AM – 6PM
Wednesday:  8AM – 8PM
Thursday:  8AM – 6PM
Friday:  8AM – 5PM
Saturday:  8AM - 12PM
Sunday:  CLOSED

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EMERGENCY INFORMATION
LOCATION
AND DIRECTIONS

Salem Veterinary Hospital
2159 Lynnhaven Parkway, Suite 105B
Virginia Beach, VA 23456
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Phone (757) 427-2222
Fax (757) 467-5699
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  • Home
  • About Us
    • Services >
      • Bathing & Boarding
      • Preventative Medicine
      • Comprehensive Physical Exams
      • Laboratory & Diagnostic Services
      • Dentistry
      • Online Pharmacy
      • Soft-Tissue Surgery
      • Cold Laser Therapy
    • Hospital Tour
    • Meet Our Team
    • Employment >
      • Online Application
  • Pet Parent Portal
    • Online Forms
    • Trusted Websites
    • Our Favorite Pets
    • Payment Options
  • Contact
  • Emergencies
  • Monthly Newsletter