Sedation Release Form

Save time during your appointment. Complete your sedation release form online from any device before your visit.

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Sedation Release Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s) before your visit.

OR

You may use the PDF version by clicking the DOWNLOAD FORM button and completing the printed form by hand. Please bring the completed PDF form for your pet’s appointment.

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Some procedures, due to discomfort, or patient anxiety or positioning (i.e. radiographs), are best performed with sedation.  Sedation helps relieve patient anxiety, allows for proper positioning, and permits mildly uncomfortable procedures to be performed in  a humane manner. 

My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction: 

  • The reasonable medical treatment options for my pet  
  • Sufficient details of the procedure to understand what will be performed  
  • How fully my pet will recover and how long recovery will take 
  • The estimate of the fees for all services  

Financial responsibilities for services are due at time of discharge. I also understand that Cranston Animal Hospital is not  staffed 24 hours a day and after hour treatment of patients is at the discretion of the veterinarian. 



I, the undersigned owner or agent of the pet named above, certify that I am 18 years of age or older and authorize the  veterinarians of Cranston Animal Hospital to treat or perform needed procedures on my animal. You are to use all reasonable precautions against pain, injury, or escape of my animal. You will not be held liable or responsible in any manner for unforeseen incidents or accidents caused by the care, treatment, or safekeeping of my pet. It is thoroughly understood that I assume all risks, and that some risks always exist with sedation, including prolonged recovery, injury while sedated, insufficient sedation for the planned  procedure, unusual behavior (aggression) while the patient is recovering from sedation, and (very rarely) death due to unexpected  heart or breathing problems during sedation.