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Anesthesia and CPR Consent Form

Anesthesia and CPR Consent Form 2026

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4.4 out of 5

32 votes

The document is an Anesthesia and CPR Consent Form for pets, outlining the risks associated with sedation and surgical procedures. It details the preparation, monitoring, and potential need for CPR during the procedure. Pet owners must indicate their preference for CPR treatment or a do-not-resuscitate (DNR) order. The form also includes questions about the pet's health history and offers additional services while under care.

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Click ‘Get Form’ to open the Anesthesia and CPR Consent Form in our editor.
Begin by entering your pet’s name and the procedure being performed in the designated fields.
Fill in your emergency contact name and number, ensuring that this information is accurate for any urgent situations.
Review the consent statement regarding anesthesia risks. This section emphasizes the importance of discussing any concerns with your veterinarian.
Indicate your choice regarding CPR treatment by initialing one of the options provided: either agreeing to CPR treatment or selecting DNR (do not resuscitate).
Answer the health history questions about your pet, including their last meal, any adverse reactions to anesthesia, current medications, and additional services you may want during their care.
Select your preference for receiving discharge sheets—either via email or print—and provide your signature along with the date at the bottom of the form.

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Versions	Form popularity	Fillable & printable
2022	4.5 Satisfied (28 Votes)
2016	4.4 Satisfied (32 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

How do you write a consent form for surgery?

1) I have read and understood the information contained here; 2) I have been informed about the Procedure and the potential risks, benefits, alternatives and the risk of those alternatives; 3) I authorize and consent to the performance of the Procedure as described; and 4) I authorize and direct that any Specimen

What is an example of consent for anesthesia?

I hereby consent to the anesthesia service checked above and authorize that it be administered by or his/her associates, all of whom are credentialed to provide anesthesia services at this healthcare facility. I also consent to an alternative type of anesthesia, if necessary, as deemed appropriate by them.

Do you need informed consent for anesthesia?

Informed consent is an essential process that healthcare providers must follow before any procedure or treatment. Informed consent also applies separately to consent for anesthesia used during procedures or treatments.

How to consent for anaesthesia?

Respond fully and record your discussions. Note the risks, benefits and alternatives (including no treatment). A separate consent form is not required for anaesthetic procedures undertaken to facilitate another treatment. Consent is an ongoing process and may require repeated discussion.