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12117 Manchaca Rd, Austin, TX 78748
512-VET-CARE / 512-838-2273
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Surgical Anesthesia Consent
Pet's Name
*
Owner's Name
*
First
Last
As owner (or agent for the owner) of the pet mentioned above, I give consent to MANCHACA VILLAGE VETERINARY CARE ("MVVC") to perform the following procedures: (check all that apply)
Spay
Neuter
Dental Cleaning
Extractions
Lump Removal
Other: (please describe)
Consent
By initialing below, I authorize MVVC to perform emergency, anesthetic, or surgical procedures that may be necessary for treating and maintaining my pet’s well being. While I expect all procedures to be performed to the best of the staff’s ability, I realize the hospital makes no guarantee or warranty regarding the results. If my animal should injure itself, escape, fail to eat, become ill or die, I will not hold MVVC or it’s employees responsible. I expect the use of reasonable precautions to ensure my pet’s safety, and I agree to pay in full when the pet is discharged.
By initialing here, I acknowledge that the surgical risks have been explained to me.
*
Choose how you would like to be reached TODAY
*
Call Me
Text Me
Call or Text me at THIS number
*
I am available to pick up my pet:
*
Anytime
After 10am
After 11am
After 12pm
After 1pm
After 2pm
After 3pm
After 4pm
Choose all that apply:
Please Check:
*
I am aware that my pet may be shaved to allow IV Catheter placement and venous access.
Please Check:
*
I am aware that each and every admitted pet is checked for fleas and ticks. If fleas or ticks are found, a flea/tick treatment will be given to my pet ($9 fleas and/or $22 for ticks)
Spays and Neuters ONLY
I understand that complication fees will be incurred if my pet has the following conditions prior to surgery: FEMALES: Estrus ($46.93), Early Pregnancy ($46.93) or MALES: Cryptorchid ($105.13)
Dental Procedures ONLY
I understand all extractions or other corrective measures will be performed at a later date unless previously discussed and approved in writing. Any abnormalities found on x-rays will be discussed at time of patient discharge with the veterinarian.
Optional services. Choose all that apply:
Laser Surgery
I have been told about the option of precision laser surgery and its benefits to my pet, and authorize its use during the procedure(s) listed above. The additional cost for this service is $67.24.
NO, thank you.
HomeAgain™ Microchip Implant Consent
I have been told about the benefits of Microchips for lost pets, and how it works. YES, I would like to have a microchip implanted in my pet while he or she is under anesthesia. I choose the discounted package (Microchip, Implantation and Chip Registration) for $40.
NO, thank you.
Home
New Clients
What to Expect
Take A Tour
Scheduling
Online Forms
Payment Options
About Us
Contact Us
Our Team
Less Stress
Testimonials
Careers
MVVC Gives Back
MVVC News
Specials
Services
Bathing, Grooming & Spa Packages
Boarding
Dental Care
Early Drop Offs
General Surgery & Outpatient Procedures
Laboratory and Diagnostics
Laser Surgery
Microchips
Pain Management
Progressive Anesthesia
Preventative Health Care and Vaccinations
Radiology / Digital X-Ray
Senior Pet Wellness Program
Spay & Neuter
Stem Cell Therapy / PRP / Growth Factor
Ultrasound
Resources
MVVC COVID-19 Protocol
Doctor Blog
Pet Health Library
How-To Videos
Pet Health Checker
Pet Food Recalls
New Pet FAQ
Dangerous Toxins
Pet Safety & Convenience Tips
Pet Health Insurance
Area Dog Parks
Flying with Pets – Airline Policies
Dog Friendly Restaurants
Adopting & Rehoming Pets
LOST PETS: What To Do First!
Dealing with Pet Loss
More Helpful Links
Pharmacy