West Alabama Animal Clinic
SEDATION RELEASE
Today’s Date: _________________________________________________________________________
Pet’s Name: __________________________________________________________________________
Owner’s Name: _______________________________________________________________________
Today’s Contact Number: _______________________________________________________________
Reason for Pet’s Visit: __________________________________________________________________
____________________________________________________________________________________
SEDATION MAY BE NECESSARY TO PERFORM SOME PROCEDURES.
MAY WE SEDATE YOUR PET IF NEEDED?
_____
YES
_____
NO
_____
CALL FIRST
The Medical Health Care Team at West Alabama Animal Clinic strives to provide the highest quality of patient care.
Our greatest concern is the well being of your pet. Therefore, before putting your pet under anesthesia today, a
doctor will perform a full examination. Depending on the doctors’ discretion, a pre-anesthetic blood profile may be
performed, in clinic, to maximize your pet’s safety and alert the doctors to the presence of conditions that may
complicate the procedure yet may not be apparent on physical examination. In addition, an intravenous catheter
may be placed and your pet may receive intravenous fluids while under sedation to help maintain adequate blood
pressure, oxygenation and provide immediate access to a vein if needed.
I understand that some risks always exist with any anesthetic procedure and that I have discussed any concerns I
have about the procedure or charges that may incur. My signature on this form indicated that any questions I have
have been addressed.
Signature ____________________________________________________________________________
All dogs being admitted to the clinic are required to be current on Rabies, Distemper and Bordetella vaccines.
All cats are required to current on Rabies and FVRCPC vaccines.
Also, any pets found to have fleas or ticks will treated at the owner’s expense.