Ultrasound Consent Form

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Ultrasound Consent Form

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Procedures are performed at the Durham Office

I hereby authorize Falconbridge Animal Hospital and its agents to perform an ultrasound on my pet. I am aware that it is important that my pet remains very still during this procedure and it is sometimes necessary to sedate pets to achieve this. I am aware that the doctor will have to make this decision without contacting me but that reasonable means will be used to perform the ultrasound without sedation. I understand the nature of the procedure and that there may be risk involved. Further, no guarantee has been made as to results or cure. I am aware that my pet’s fur will be shaved to facilitate proper imaging.

I understand that in the event that additional procedures are deemed necessary, an attempt will be made to reach me before proceeding, but I understand that the veterinarians are authorized to perform any necessary procedures if they are unable to reach me.

I understand that current Wellness. Exams, Distemper, and Rabies vaccines are required for all pets, as well as Parvo, Bordetella, Flu Vaccine (H3N2), and a Fecal Flotation for dogs, before admission to the hospital. Pets not current on vaccines/testing will be updated as long as it is deemed safe and advisable by a veterinarian.

I certify that to the best of my knowledge my pet is free of all external parasites upon signing this release. If parasites, such as fleas or ticks, are found, I understand that my animal will be treated on admission for an additional cost.

Other services desired at an additional cost

My pet has fasted for 12 hours*

My pet is on heartworm prevention*

Ultrasounds are performed by a mobile service and may be performed as early as 8:00 AM or as late as 5:00 PM. Please plan to pick your pet up between 5:00 PM and 5:30 PM unless told otherwise.

A basic, single area ultrasound is $395 without sedation; sedation fees vary based on the individual needs of patients. I understand that all charges are my responsibility and that payment is expected at the time of discharge.

Falconbridge can use my pet’s photos on FalconbridgeAnimal.com and their social media pages. (Like us on Facebook & follow us on Instagram)

Falconbridge can use my pet's photos on social media*

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