中英文版麻醉及手术协议书范本模板

麻醉协议及手术协议书

An esthesia protocols and operati on agreeme nt

我是上述动物的主人或者是可以代表上述动物的监护人，我愿意接受医生及其助理为动物进行上

述操作，包括镇静或者麻醉，以及给动物必要和适当的药物、x线检查、外科操作、护理、诊断,

甚至紧急的抢救。我已经被告知整个操作的过程以及可能的风险。我认识到动物在麻醉中由于个

体因素发生的药物反应、窒息、心跳骤停等意外情况，甚至死亡，一切责任由自己承担，与

动物医院及实施麻醉和外科操作的人员无关。我同时也理解任何操作和治疗

都没有百分之百成功的保证。

I am the owner of the an imals or can represe nt the an imal's guardia n ，I am willi ng to accept the doctor and his assistant for the operation to the animals ，Include sedation

or an esthesia, and give n ecessary and appropriate ani mal drugs, X-ray, surgical operati on, n urs ing, diag no sis, and emerge ncy rescue. I have bee n told that the en tire operating process and possible risks. I realize that animals reaction of the drug in

an esthesia because of in dividual factors, asphyxia, cardiac arrest and other accide nts and even death,all the responsibility borne by himself, with hospital and an aesthesia and surgical operati on. I also un dersta nd n either operati on and treatme nt is one hun dred perce nt guara ntee of success.

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