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Dental Care Consent

Please help us provide the best care for your pet by responding to the following questions prior to your pet's scheduled appointment. This will save time for you and us before starting your pet's appointment. Thank you!

I have been informed that my pet is in need of preventive or therapeutic dental care and hereby consent to the appropriate
procedures described to me by my veterinarian. By signing this document I certify that I own or have 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 my pet. I also understand that by signing I am taking full responsibility for payment, treatments, and procedures upon discharge of my pet.

Valley West Veterinary Hospital doctors and staff members will call the given number for verbal authorization of additional services, however since your pet will be under anesthesia at the time of the call, it will be at the doctor's discretion to proceed with what is medically necessary for your pet.

ADMISSION REQUIREMENTS: In order to be admitted for surgery, your pet must be up to date on his/ her wellness exam and necessary vaccines (Rabies, Bordatella, DHLPP, and FVRCP). If your pet is not up to date, these vaccines will be given.

PAIN MANAGEMENT is an essential component of all dental procedures. Depending on the severity of the dental disease, the doctor may opt for injectable pain medication, local blocks (numbing) for extractions, and/or pain medications to go home. Your signature below provides consent for the pain management protocol that the doctor deems appropriate for your pet, based on the extent of the dental procedures.

PRE-ANESTHETIC SCREENING (ADDITIONAL COST) The purpose of pre-anesthetic screening is to assess the risk associated with sedating and/or anesthetizing your pet, however, please note these tests are only a guide and do not eliminate all risks. Specifically, an ECG is a tool used to assess the rate and rhythm of a patient's heart. This is of particular significance when under anesthesia and may also help in the early detection of cardiac disease. The lab work gives us insight into the breakdown of the drugs used for sedation and anesthesia by looking at liver and kidney functions, blood sugar levels, potential sites of infection, and again may help in the early
detection of disease.

Does your pet need any additional services while with us today? These are at an additional cost. (Please select all that apply)
Would you like to have your pets "before and after" dental pictures emailed to you?
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.
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  • Valley West
    301 Virginia St W
    Charleston, WV 25302
  • (304) 915-0944
  • staff@valleywestvets.com

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    913 Old Frame Rd.
    Elkview, WV 25071
  • (304) 915-0790
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