Dental Consent Form

Please only use this form if directed to by a member of Craig Road Animal Hospital’s staff as this form is used to authorize us to clean your pet’s teeth.

    Dental care is an important part of your pet’s overall health regimen, and is a special feature among our clinic services. Some of our dental services include dental scaling and polishing, oral surgery, root canals, and vital pulpotomies.

    Pet Information

    I am the owner/agent of the described animal and have the authority to execute this consent. I hereby authorize consent for Craig Road Animal Hospital Staff to perform a dental cleaning and a polishing.

    Preoperative Blood Work (please select one of the following options)

    Preoperative blood testing can screen for liver and kidney diseases, anemia, and other disorders that may be present and may place your pet at an additional risk. Preoperative profile with complete blood count is recommended for patients < 5-years-old. A complete Chemistry Profile and complete blood count is mandatory for patients > 5-years-old, and those that have pre-existing medical conditions. Once your pet is under anesthesia, our doctors and dental technicians will be able to perform a more complete oral exam. During this oral exam we may find teeth that need to be radiographed and/or extracted that were not obvious on the initial dental exam.

    I DO give consent for Craig Road Animal Hospital to perform blood work on my pet.I DO NOT give consent for Craig Road Animal Hospital to perform blood work on my pet.

    Dental X-Rays (please select one of the following options)

    Dental x-rays, or radiography, has greatly enhanced the way we, practice veterinary dentistry. So much of dental disease, such as periodontal disease, tooth root abscesses, jaw fractures, tumors, etc., occurs below the gum line that only can be found with dental radiography. Dental radiography also allows for diagnosis of certain diseases, plan for the appropriate treatment as well as monitoring for treatment success. It will help us stage teeth for further treatment.

    We recommend full mouth dental radiographs on all pets when they are having their dental cleaning done. We may find abnormal teeth that were not visible during the complete oral exam. The cost for full mouth diagnostic radiographs will be detailed on your estimate. Post extraction radiographs are an additional fee and will also be on your estimate. In order to prevent excessive anesthesia time please indicate how you would like us to contact you and/or proceed with your pet's dental.

    I DO give consent for Craig Road Animal Hospital to perform dental x-rays on my pet.I DO NOT give consent for Craig Road Animal Hospital to perform dental x-rays on my pet.

    In the event any adverse medical problems occur because of my decision not to treat my pet's dental issues, I accept full financial responsibility and I hereby, release Craig Road Animal Hospital and all staff members of all responsibility for my decision. Please select one of the following options:

    APPROVE: I approve all necessary dental procedures needed at this time. I accept full responsibility of financial charges associated with this decision.DO NOT APPROVE: I would only like to be called in an emergency situation. Do not perform any additional dental work. A treatment plan will be provided to me at time of discharge.

    Cardiac Circulatory Pulmonary Resuscitation (CPR) Consent (please select one of the following options)

    I understand that risks and potential complications exist with anesthesia surgery and do not hold Craig Road Animal Hospital liable for those risks. The attending veterinarian will perform any necessary lifesaving emergency care and I agree to assume all financial responsibility associated with my decision.

    I DO give consent for Craig Road Animal Hospital to perform CPR.I DO NOT give consent for Craig Road Animal Hospital to perform CPR.

    By writing your name, you are agreeing to the terms and conditions as stated above. In the event any adverse medical problems occur because of my decision not to treat my pet's dental issues, I accept full financial responsibility and I hereby, release Craig Road Animal Hospital and all staff members of all responsibility for my decision. I understand payment is due in full at time of discharge. By signing below, I indicate that I understand this consent and I have an agreement with Craig Road Animal Hospital.

    Emergency Contact Information (recommended)

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    Contact info:

    phone: 702.645.0331
    fax: 702.645.5009

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    5051 W. Craig Road Las Vegas, NV 89130
    Business Hours
    6am - 8pm Monday - Friday
    7am - 6pm Saturday and Sunday

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    We Accept the Following Payment Options:
    trupanion pet insurance

    • After 8PM emergency care provided by Veterinary Emergency Critical Care
    • On-site staffed 24/7/365
    • 10% Military Discounts on services

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