Pre-Dental Consent Form Pre-Dental Consent Form Name * Name First First Last Last Phone * Have you read and understood the “Dental procedure information sheet”? If you have not received this information, please let us know. * Yes No A complete examination of your pet’s mouth is not possible until your pet is asleep under the general anaesthesia. A full examination consists of the vet probing your pet’s teeth and taking dental radiographs which will highlight any diseases that may be hidden beneath the gum line. After this is complete, we can then identify whether any teeth require extraction. If the costs exceed your original estimate, then we will ALWAYS attempt to contact you prior to removing these unexpected diseased teeth. The following consent is about knowing your wishes if we cannot get in contact with you for any reason. Keeping anaesthetic times at a low is a high priority for the safety of your pet and is why we cannot wait for you return our call. If you do not answer your phone, do you (please tick your preferred option): * Give us consent to perform these extractions or any treatment necessary and accept the additional costs. NOT give us consent to perform these extractions and for my pet to be woken up from anaesthesia WITHOUT the diseased teeth removed. **Please note that we only remove teeth that are absolutely necessary. If you select option 2, at your pets discharge the vet will discuss with you a plan to have these teeth extracted during another anaesthetic. Secondary contact:Do you have someone else that we can call and who can give us consent to go ahead with any unexpected extractions if we cannot get in contact with you? If so, please provide their name and contact number below. Name Name First First Last Last Relation Phone ** Please note that payment is required when you collect your collect your pet. Should you require payment assistance please contact us to discuss the option of Vetpay prior to the day of your pet’s procedure. If you have any questions or concerns about your pets upcoming dental procedure, then please reach out to us on 9470 4445. Captcha Submit If you are human, leave this field blank. Contact Us Email Us lathlain@petsandvetswa.com.au (08) 9470 4445 Mon - Fri: 8am - 6pmSaturday: 9am - 3pmSunday: closed Facebook @VicParkLathlainVets Instagram @petsandvets_wa Contact Form * * * reCAPTCHA Submit If you are human, leave this field blank.