As part of your pet’s dental cleaning under anesthesia, we will examine each tooth and take radiographs to thoroughly evaluate your pet’s mouth. Dental disease may be diagnosed that could not be detected in an awake pet. Your pet therefore may need additional treatment beyond your initial dental treatment plan (estimate). Prior to proceeding with any additional treatments, we will attempt to contact you to discuss your pet’s revised treatment plan and associated costs.
Additional treatments may include oral surgery, extended anesthesia, local nerve blocks, medications to alleviate pain, antibiotics, and Consil (a synthetic bone to promote bone regeneration). These additional fees may range from $200-$1000 depending on the extent of additional treatment needed.
Since your pet will be under anesthesia, we need to be able to speak to an authorized adult when we call. In the event I am unable to be reached at my contact number during my pet’s procedure:
________I AUTHORIZE any additional necessary procedures and 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.
_______ I DECLINE any additional procedures at this time. I understand any recommended treatments can be performed at a later date, but will require my pet being anesthetized again. We recommend completing all necessary dental procedures during this visit so you can avoid scheduling another appointment with additional anesthesia costs.
Owner Signature Date
Contact Phone Number