Sedation Form | Animal Medical & Surgical Center

If your animal is scheduled for a procedure involving sedation at the Animal Medical & Surgical Center of Coshocton, please complete this form in advance. Providing accurate health history and medication information helps our veterinary team plan the safest sedation protocol for your animal.

Complete Our Sedation Form

Please complete all fields carefully and submit before your animal’s scheduled sedation procedure. Contact us at (740) 622-0013 if you have any questions or concerns before your appointment.

Pet Information

Contact Information

* This person has your authority to consent to medical decisions regarding your pet's surgical care in the event we cannot reach you.

Additional Services Desired While Patient Is Sedated

Authorization

Clear Signature