Pet Orthopaedic Solutions
Consent form
This is ensure that you (owner) has given consent for your pet to undergo orthopaedic surgery today at (practice name below)
_________________________________________________________________________________ .
This surgery has been arranged by your own veterinary team and is being carried out by an external referral company. This company is called Pet Orthopaedic Solutions ltd. Fergus Ryan MVB CertSAS
RCVS is the Veterinary Surgeon and RCVS certificate holder in Small Animal Surgery who will be carrying out the surgery. I understand that the surgery is being carried out by a third party and that my dogs aftercare will be monitored by (practice name below)
_________________________________________________________________________________ who will have direct contact with Pet Orthopaedic Solutions. This agreement is in addition your practices own consent form that will also be signed on the day of surgery.
I herby give permission for my pet to undergo an anaesthetic and the surgical procedure that has been explained to me today. I understand what the procedure involves and any aftercare that is required. I understand that all general anaesthetics and surgical procedures carry a certain degree of risk and understand these risks that have been discussed with me today.
Owner/representative, over the age of 18 years old:
Signed:________________________________
Print:__________________________________
Date: __________________________________
Pet Orthopaedic Solutions:
Signed:__________________________________
Print:____________________________________
Date:_____________________________________
Fergus Ryan MVB CertSAS MRCVS and Rebecca Ainsley RVN
Tel: 07769 220228 or 07585 667417
Email: info@pet-orthopaedic-solutions.co.uk
www.pet-orthopaedic-solutions.co.uk