We offer same day appointments Monday through Saturday!

Surgical Admissions Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Authorization and consent for professional services

It is important to understand that all reasonable precautions will be taken to protect your pet and assure the best possible results. Please read this information sheet carefully and feel free to express any concerns you may have. 

Fields marked with an * are required
All animals entering Park Ridge Animal Hospital must be up-to date on vaccinations and free of external parasites, or they will be treated upon entry at the owner's expense.
  • I am the owner, responsible agent for, or authorized agent of this animal and I am 18 years of age or older.
  • I understand the nature of the procedure(s), that there are risks involved with any surgery or procedure, and that no guarantees are made as to the results or cure. I understand that sedation or general anesthesia may be necessary to relieve anxiety during procedures and/or to insure the safety of pets and employees.
  • I authorize the veterinarians and the staff of Park Ridge Animal Hospital to perform all procedures as set forth in the attached "Estimate," including surgery, medical services, treatment, laboratory tests, x-rays, medications and anesthetics.
  • This veterinary facility does NOT provide after normal business hours supervision by a person physically on these premises for pets that are treated at this veterinary facility. Your signature on this document confirms that you have been notified of the absence of personnel after normal business hours at this veterinary facility.
  • I agree to pay in full for services performed including those deemed necessary for medical or surgical complications or unforeseen circumstances and pay a 50% deposit the morning of surgery.
  • Park Ridge Animal Hospital will use all reasonable precautions against injury, escape or death of my pet, but will not be held responsible in connection with or in any manner, as it is thoroughly understood that I assume all risks.
  • I have read and understood this authorization and consent