[ Client Resources ] CPR Consent Form CPR Consent Form CPR Consent Form CPR Consent Form Name Name First Name First Name Last Name Last Name Email * Pet Name * Resuscitation Orders Agreement Resuscitation Orders in the Event of an Emergency: For every cat in our care, we need to know, in advance, what your wishes are in the unforeseen event of an emergency if he or she stops breathing and/or their heart stops beating. CPR has the best chance of being successful if started immediately. We will make every attempt to contact you right away should your cat require resuscitative efforts. Please review and select one option below. Cardiopulmonary Resuscitation (CPR): All resuscitative efforts including placing a breathing tube, providing chest compressions and IV medications are to be attempted to restore normal heart function and breathing as deemed necessary by the doctor until I can be reached. Should my cat require cardiopulmonary resuscitation (CPR), I request that the doctor(s) pursue such medical care indicated above. I understand that this is a cost in ADDITION to any estimate and agree to pay this fee. The cost of full CPR is typically an additional $300 - $500 or more. Patients who are successfully resuscitated are often critical and will require transfer to a 24-hour facility for at least 24 to 48 hours of intensive care and monitoring following resuscitation. Do Not Attempt Resuscitation (DNR): Aside from reversing any reversible sedatives or anesthetic drugs that have been administered, no cardiopulmonary resuscitation (CPR) efforts are to be attempted allowing natural death. Be assured that we do everything possible to prevent this from happening and electing DNR does not affect selected treatments. Please select one of the following: * Cardiopulmonary Resuscitation (CPR) Do Not attempt Resuscitation (DNR) If you have any questions please ask to speak to your DVM. Signature * signature keyboard Clear Today's Date * Submit If you are human, leave this field blank.
