Dental Consent Form

Please complete the form below before your appointment. if you have questions, please call us at 785-267-1012.

Your pet is scheduled for a dental procedure at Burlingame Road Animal Hospital. We utilize the safest anesthetics and maintain continuous monitoring throughout the process. It's important to note that all anesthetics and surgical procedures carry inherent risks, irrespective of the pet's age or health condition

All admitted animals must have up-to-date vaccinations and be free of external parasites. Any instances of fleas or ticks will be treated at the owner’s expense.

Adhering to the gold standard of care, dental radiographs are routinely taken during the dental procedure to assess potential tooth extractions. In the event we are unable to reach you to discuss a treatment plan post radiographs, we offer the following options for your consideration.


Please check your choice below:

Your signature below confirms that:

    ✓ You have read this form

    ✓ You understand that there are risks associated with anesthesia and surgery, and

    ✓ Payment for all treatments is due and payable when you pick up your pet.