LUMPECTOMY CONSENT FORM

Operation / Procedure

I hereby give permission for the animal described above to be given an anaesthetic and / or analgesic together with any other procedure which may prove necessary.

I understand that all anaesthetic techniques and surgical procedures, no matter how small, involve some risk to the animal. Modern techniques however reduce this to a minimum.

• Does _________________________ have any medical conditions or has he / she had an adverse reaction to an anaesthetic as far as you are aware?
• We offer in-house pre-anaesthetic blood testing. The cost is _______________. Would you like this carried out on ___________________ prior to this procedure?
• I understand that full payment for the above procedure is due at the time of collection. I am over 18 years of age.

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