Dental Consent Form

BAH Color LogoWe provided you with an estimate for your pet’s dental procedure that we think is inline with the extent of your pet’s oral infection.  While your pet is under anesthesia for the dental procedure, we’ll be able to more throughly examine your pet’s teeth and radiograph the whole mouth.  This information will give us a more exact understanding of the extent of the disease and we’ll be able to adjust the estimate accordingly.

If there is additional dental work that we must do based on the findings of this second examination, we recommend that you allow us to complete it at this time.  Completing all the dental work now will reduce the amount of time your pet is under anesthesia, reduce overall costs, and get your pet on the road to recovery sooner.

If we find that the extent of your pet’s oral disease is greater than what we estimated, what would you prefer that we do (check one):

________DO NOT contact me prior to performing additional necessary procedures.  I will accept full financial responsibility for all additional procedures performed above the estimate. I understand that all additional procedures will be explained to me at discharge of my pet.

_______ Please contact me prior to performing any additional procedures beyond the written estimate. I understand that a hospital representative will contact me for verbal consent regarding additional estimated costs and I CONFIRM that I will be available to speak to without delay at the following number ____________________.  I UNDERSTAND THAT IF I CANNOT BE REACHED FOR PERMISSION TO COMPLETE THE ADDITIONAL RECOMMENDED WORK, THAT THE ORIGINAL SCOPE OF WORK WILL BE COMPLETED AND THAT MY PET WILL BE AWAKENED FROM ANESTHESIA.  I understand that the additional recommended work can be completed at a later date, but will mean additional anesthesia time for my pet.

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