Surgery/Anesthesia Consent Form

  • This procedure will include preparation, anesthesia, monitoring, catheterization and fluid support, and pain management. If you would like a detailed explanation of each area covered under the procedure, please see a staff member. An information form is also available for your convenience.
  • AUTHORIZATION - I have read and understand this authorization and consent and authorize the described surgical/anesthetic procedure and anesthesia for my pet. - I have not given my pet any food after 12 AM the morning of the procedure, unless otherwise advised by my veterinarian. I understand that this is important for anesthesia safety.
  • Please list your name again as agreement to the information listed above

Contact Us

4122 Zulla Road
The Plains, VA 20198

Phone: 540-364-4954
Fax: 540-364-4987
office@piedmontsmallanimal.com



Phone: 540-364-4950

Location Hours
Monday8:00am – 6:00pm
Tuesday8:00am – 6:00pm
Wednesday8:00am – 6:00pm
Thursday8:00am – 6:00pm
Friday8:00am – 6:00pm
Saturday8:00am – 12:30pm
SundayClosed