Edgewood Animal Clinic

1708 East Edgewood Drive
Lakeland, FL 33803




Surgical Release Form


I hereby authorize and direct the veterinarians of Edgewood Animal Clinic to perform the procedures and additional diagnostic and/or treatment procedures as deemed advisable for my pet. The nature of the procedure(s) has/have been explained to me and no guarantee has been made as to the results or cure.

Please be assured that we use the safest anesthetics available and constantly monitor your pet throughout the procedure. Regardless of age and health, all anesthetic procedures have an element of risk.

Because there is always the possibility a physical exam alone will not identify all your pet's health problems, we require that pre-anesthetic blood tests and an EKG be performed on all pets prior to the administration of anesthesia. These tests can help us detect anemia, dehydration, diabetes, heart irregularities, kidney and liver disease. All these conditions can contribute complications in anesthesia and surgery. In the event an abnormal test occurs, additional testing will be required to rule out complications. This evaluation is valid for six months only.

It is important to understand that a pre-anesthetic profile does not guarantee the absence of anesthetic complications. It may, however, greatly reduce the risk of complications as well as identify the conditions that would require treatment in the future.



Surgery Release Form

First Name
Last Name
First Name
Last Name

Surgical Procedure

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