A surgical procedure is to be performed on and general anesthesia is _____(Scheduled Date)_____ required to perform this procedure. We monitor and maintain your horse through this entire procedure. We use multiple monitors that include pulse oximetry, and end tidal CO2, ECG, blood pressure, and blood gasses. There are always risks associated with any procedure, with this procedure there is a low risk of anesthetic death through no fault of anyone. It is a possible complication, but the risk of complication is very low (1% or less). Due to the nature of the horse, horses need to stand up after surgery. They are monitored and rope recovered. Complications are very low but they can arise during the recovery phase. Some of the complications can include fractures, neuropraxia, unable to rise, cardiac arrest, and cardiovascular failure.

I, _____(Owner's Name)_____, understand the risk of anesthesia to my horse, _____(Horse's Name)_____ and accept the risk of anesthesia.