We will be closed for the 4th of July.  Please reach out to Kanawha Valley Veterinary Emergency Hospital if your pet is facing an emergency while we are closed. 

Hours & Contact
  • Valley West
  • (304) 915-0944
  • staff@valleywestvets.com
  • Elk Valley
  • (304) 915-0790
  • staff@elkvalleyvets.com
  • facebook
  • facebook
  • instagram
  • tiktok
Valley West Veterinary Hospital
Main Menu
Menu
  • Home
  • About Us
    • Meet the Team
      • Client Service Representatives
      • Managers
      • Veterinarians
      • Veterinary Assistants
      • Veterinary Technicians
    • Professional Associations
    • Photo Gallery
    • Careers
    • Our Culture
    • Cat Friendly Gold Practice
    • Appointment Info
  • Services
    • Cat Services
      • Cat Acupuncture
      • Cat Anesthesia
      • Cat Cancer
      • Cat Dental
      • Cat Dermatology
      • Cat Diagnostic Imaging
      • Cat Fleas & Ticks
      • Cat Grooming
      • Cat Heartworms
      • Cat Lab Tests
      • Cat Laser Therapy
      • Cat Medications
      • Cat Microchipping
      • Cat Nutrition
      • Cat Preventive Care
      • Cat Spaying & Neutering
      • Cat Surgery
      • Cat Vaccinations
      • Cat Wellness Exams
    • Dog Services
      • Puppy Care
      • Senior Dog Care
      • Dog Acupuncture
      • Dog Allergies
      • Dog Behavior
      • Dog Cancer
      • Dog Dental
      • Dog Deworming
      • Dog Diagnostic Imaging
      • Dog Fleas & Ticks
      • Dog Heartworms
      • Dog Lab Tests
      • Dog Laser Therapy
      • Dog Microchipping
      • Dog Nutrition
      • Dog Pregnancy
      • Dog Preventive Care
      • Dog Spaying & Neutering
      • Dog Surgery
      • Dog Vaccinations
    • General Services
      • Boarding
      • Dentistry
      • Digital Radiology
      • Emergency Veterinary Care
      • Pain Management
    • Livestock and Equine
  • Locations
    • Elk Valley
    • Valley West
  • Resources
    • Forms
    • Request a Refill
    • Payment Options
    • Helpful Links
    • Breeds
      • Cats
      • Dogs
  • Blog
  • Request an Appointment
    • Elk Valley
    • Valley West
Request an Appointment

Anesthesia / Sedation Consent Form

I. ADMISSION REQUIREMENTS: In order to be admitted to the hospital, your pet must be up to date on his/her wellness exam and necessary vaccines (Rabies, Bordatella, DHLPP, and FVRCP).

Routine Medications: Is your pet on any daily medications?
If yes, were they given this morning

II. PRE-ANESTHETIC EXAMINATION AND BLOOD TESTING: Although most animals tolerate anesthesia, there is an inherent risk, even in healthy pets. To provide the best conditions possible for anesthesia, a veterinarian first assesses your pet during a pre-surgical exam. This exam is important and provides a portion of our pets health status. In addition, we highly recommend a pre-surgical blood panel, similar to what humans receive, to obtain a further diagnostic picture of your pets health. The reason for this panel is two-fold: 1) Blood tests might reveal hidden abnormalities that would put your pet at greater risk for anesthetic complications. In this case, we would postpone surgery and recommend needed treatment. 2) This panel would serve as a reference (what is normal for your pet) as your pet ages, becomes ill, or needs possible emergency treatment in the future. 

Please select one of the following options below:

III: ANESTHESIA CONSENT: I authorize Valley West Veterinary Hospital to perform a procedure on my pet that requires anesthesia. I understand that results cannot be guaranteed, and that anesthesia and surgery always carry potential risks to the life and health of my pet. I am aware that in rare cases, medical complications may arise which will be treated in a prompt manner by the medical staff of Valley West Veterinary Hospital,. I assume full financial responsibility for this animal, for all the procedures required and requested either on this form or by phone. 

In the event that your pet experiences cardiac or respiratory arrest while under our care, do you consent to the veterinary team performing Cardiopulmonary Resuscitation (CPR) in an attempt to revive your pet? CPR may include chest compressions, artificial ventilation, and emergency medication. Please note that while CPR can be life-saving, it does not guarantee recovery and may involve additional costs. Kindly indicate your preference by selecting the appropriate option below, understanding that this decision is critical in an emergency situation. 
Do we have consent to send you text messages during/after your pets procedure to let you know how he/she is doing?
Valley West Veterinary Hospital will not be responsible for any charges you may receive as a part of your personal telephone plan. 

By Signing this document you certify that you own or have the permission of the owner to consent Valley West Veterinary Hospital and its staff to hospitalize, administer treatments, and perform procedures deemed necessary by the attending veterinarian for the welfare of your pet.  I also understand that my signing, I am taking full responsibility for payment, treatments, and procedures upon discharge of the pet. 

**If you have been asked to leave a deposit it is non-refundable if the appointment is cancelled or if you do not show up. This policy helps ensure that we can provide the best care for all our patients.

Sign above
CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Share this content

  • twitter
  • email
  • pinterest
  • facebook

Review Us!

Valley West Veterinary Hospital   review us!
Valley West Veterinary Hospital
About

Come see our veterinary hospital to get the latest high-quality care & best overall experience!

Links
  • About Us
  • Services
  • Testimonials
  • Contact Us
  • Privacy
  • Accessibility
Get In Touch
  • Valley West
    301 Virginia St W
    Charleston, WV 25302
  • (304) 915-0944
  • staff@valleywestvets.com

  • Elk Valley
    913 Old Frame Rd.
    Elkview, WV 25071
  • (304) 915-0790
  • staff@elkvalleyvets.com
Review Us

  • facebook
  • facebook
  • instagram
  • tiktok
X
 Valley West
 Elk Valley

©2025 Valley West Veterinary Hospital. Resource Articles ©2025 GeniusVets. All Rights Reserved. Veterinary websites by GeniusVets