Dental Release Form

    Your pet is scheduled to have a dental. This includes scaling the teeth, a fluoride treatment and a sealant, as well as anesthesia, pre-anesthetic blood work, an IV catheter and heart and respiratory monitoring.

    Any extractions will be at an additional price, depending on severity.

    How many, if any, teeth will need to be extracted will be determined during the doctor's examination during the dental procedure.

    You may authorize these extractions now or we can call you during the procedure, although this will add to your pet's time under anesthesia.

    It is imperative that we have a telephone number in which you can be reached, especially if you would like to be called while your pet is anesthetized.

    Additional Options

    Please read, select one, and digitally sign below

    Yes, I understand the risks of both anesthesia and surgery. To reduce the risk, I understand that a pre-operative blood profile will be run to assess organ function. I also understand that my pet will be sent home with pain medication to be given at home.