GBarN Veterinary Clinic Ear Crop Consent Form
 
Date______________ Phone (Where you can be reached today)___________________
* Veterinary services during night and/or weekends is provided at the discretion of the veterinarian in charge. Continuous presence of personnel may not be provided during these hours.*
 
Ear cropping is the term for surgically altering the edge of the ear so it will stand up. 
There is no guarantee for ear cropping. ______initial
 
10-14 days after the surgery I will bring my dog back for suture removal and racking (if necessary). At that time the nurse will give instructions on how long to keep the ears racked. Eight ear rackings are included in the procedure. If more are needed they will be charged at full price ($15 each).  It can take up to 6 months for the ears to stand correctly. In some cases the ears never stand correctly. _____initial
 
After surgery, I understand I have 10 days to decide whether or not I like how the ear is cut. Up until that time I may decide to have more ear removed at no additional cost. After 10 days any additional surgery will be charged accordingly. _____initial
 
As the owner or agent of the above animal, I hereby give my consent to G-N Veterinary Clinic to perform the ear crop. I understand that during the performance of this procedure unforeseen circumstances may occur that may necessitate a variance in the procedure above. I expect G-N Veterinary Clinic to use reasonable care and judgment in performing the procedure(s). The nature of the procedure(s) and risks involved has been explained to me and I realize the results can not be guaranteed. I am also aware that unforeseen events resulting from the procedure(s) will not relieve me from any obligation to all reasonable costs incurred regarding the animal.
 
            __________________________
            Owner/Agent
 
*All animals admitted must be free of external parasites. Any animal found to have fleas or ticks will be treated at the owner’s expense.*
 
PRE-ANESTHESIA REQUEST
______ A.I refuse preanesthetic screening.
______ B.Preanesthetic mini screen $57.35
______ C.Preanesthetic screen (CBC/Chem12) $182.50

______ D. Panel (required for animals over 8 years old)(CBC/Thyroid/Chem 12) $212.50