Dade City Animal Clinic Dental Consent Form

Save time during your next appointment! Complete your required forms online from any device at any time before your visit.

Dental Consent Form

Please fill out this form as completely and accurately as possible before your visit.

I hereby give my consent to DADE CITY ANIMAL CLINIC to perform a dental prophylaxis (scaling and polishing) of the patient's teeth under general anesthesia. This form also gives consent for the Doctor to use his discretion and to perform any extractions deemed necessary to the general health of the patient.


If your pet is to be anesthetized, we are confident that advances in anesthesia and dental medicine have made routine procedures relatively safe with a low rate of complications. Ocasionally, problems can arise due to pre-existing conditions that are not evident during routine pre-anesthetic physical examinations. To reduce the risk of complications, we recommend that all patients be screened prior to anesthesia by means of the following laboratory tests. These tests will be performed at your expense unless you decline them by checking and signing below.

Pre-Surgical Options

Please check any vaccines you would like your pet to receive.