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AGAINST MEDICAL ADVICE 

DATE OF PROCEDURE
Day
Month
Year

  • I UNDERSTAND THAT PRE-ANESTHETIC BLOODWORK IS IMPORTANT FOR IDENTIFYING UNDERLYING HEALTH ISSUES THAT COULD INCREASE RISKS DURING ANESTHESIA. BY DECLINING BLOODWORK, I UNDERSTAND AND ACCEPT THE INCREASED RISK OF UNDETECTED CONDITIONS AND ANY COMPLICATIONS THAT MAY OCCUR.

  • I AGREE THAT CHEW ANIMAL HOSPITAL AND ITS EMPLOYEES WILL NOT BE HELD RESPONSIBLE FOR ANY OUTCOMES RELATED TO THIS DECISION.


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