ANESTHESIA FORM

Please complete this form before your visit.

Please allow 24 to 48 hours for a response.

A pre-anesthesia blood screen is recommended for all pets but is required for pets 7 years of age and older, prior to anesthesia. If all of the tests are normal, it does not guarantee that your pet will not have an anesthetic reaction, but it does tell us that your pet is healthy and in a low-risk category. If any of the test results are abnormal, the doctor will call you to discuss how to proceed. This blood screen includes the following tests:

Complete blood count: Detects anemia, infections, and clotting disorders

Bun and Creatine: Assesses kidney function

Glucose: Detects diabetes

ALT & ALKP: Assesses liver function

Total protein: Detects dehydration

For pets having dental procedures:

For pets having surgical removal of masses:

For pets having general surgery (spays, neuter, etc.):