Outpatient Echocardiogram Authorization Form

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Your pet is having an echocardiogram examination today, which your family veterinarian has requested. The echocardiogram examination will be done to look for any abnormalities in your pet. Typically, your pet will be taken to have the echocardiogram while you wait. Occasionally, you may be asked to leave your pet for a longer period of time.

Any medical procedure can have complications. Complications of echocardiogram examinations are very rare. Examples of risks of sedation, if necessary, include hypotension and drug reaction. Some medical conditions/diseases may put your pet at risk for complications if they need to be sedated. Examples of such conditions include: heart, kidney or liver disease, neurologic conditions that can cause seizures, certain types of cancer, pancreatitis, anemia, and excessively high or low blood pressure, among others. If you have any concerns regarding the above risks, please discuss with your family veterinarian.

Please affirm below that you understand the procedures to be done and the possible risks and complications (see below).

I give consent for the procedure and am aware of the following:

  • Your pet may be clipped (shaved) for the procedure.
  • As with all diagnostic procedures, echocardiograms may not always provide a diagnosis.
  • All communication will be through your family veterinarian.
  • If we are concerned about your pet and have to get the doctor more involved, there will be additional charges.

Following the procedure today please contact your family veterinarian to discuss the results and plan.

For Pet Families

Our team has put together helpful resources and information specifically for pet families. Click here to learn more.

For Veterinarians

To learn more about referrals to our specialty veterinary hospital, click here. We look forward to working with you!

Compassionate veterinary care for the pets of Matthews, NC and beyond.

The Skyline Veterinary Specialists team is here for you and your pets throughout every stage of their lives. From specialized to urgent care, we’ll be here for you when you need us most.

Contact Info

Phone: 704-672-5590
Fax: 704-565-4215
Email: info@skylinevetspecialists.com

Hours

Mon - Fri: 8:00 am - 6:00 pm
Sat-Sun: Closed

Urgent Care

Mon - Fri: 8:00 am - 6:00 pm

Location

2440 Plantation Center Dr.
Matthews, NC 28105

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