UltrasoundConsent Form

Make the most of your next appointment by saving time! Before your appointment, fill out your ultrasound consent form from any device at any time.

Ultrasound Consent Form

Note: In case of an emergency and/or prior to additional procedures, you will be contacted by telephone. Please keep your phone with you.

Ultrasounds at Rancho San Carlos Pet Clinic are done by a mobile service and not performed by our veterinarians. Abdominal ultrasonography is a non-invasive technique used to image organs within the abdomen and/or chest. The area to be imaged must be shaved in order to provide adequate imaging. Irritation may occur to the skin as a consequence. Hair regrowth generally takes multiple weeks to occur, but can be more prolonged in certain pets. I understand that my pet may require sedation in order to obtain diagnostic images and authorize the veterinarian to administer sedation if necessary. I understand this will incur an additional cost of $50-100.

Please acknowledge the following Information: I certify that I am the owner, or authorized agent for the owner, of the above pet. I authorize the doctor on duty and assistants to perform the above described procedures including administration of sedatives and/or anesthetics, as well as any necessary and appropriate medical, surgical, nursing, diagnostic, and/or emergency care for the above pet. I understand that Rancho San Carlos Pet Clinic is not a 24 hour hospital. Should an overnight stay be necessary, direct observation will not be available. If the above pet needs observation we recommend transfer to a 24 hour emergency hospital. I understand that I am assuming full financial responsibility for all services rendered at the time my pet is discharged from the hospital.

We place the highest priority on ensuring you feel comfortable with the plan for your pet’s care and fully understand the authorizations below above giving your consent. If you have any questions or need clarification on any of the choices, please contact the hospital so a medical team member can review the form with you prior to completing it. As always, thank you for entrusting us with your pet’s care!