Kimberley Veterinary Clinic Group Logo Icons

Blood Bank Registration Form for Dogs - KIMVET - Submit Online Multi-Step Form and Receive a copy to your email address:

1 kimberley-veterinary-clinic-blood-bank-services KIMVET SERVICE

Step 01

Please enter the details of the owner of the pet you are registering to donate blood;

Step 02

Please enter the details of the pet you are registering to donate blood;

Step 03

Consent to Procedure, Benefits and Voluntary Donation Status

  • PET OWNER'S DETAILS
  • PET'S DETAILS
  • CONSENT

Owner's Details

Pet Details:

Animal Type:

Male or Female:

Sterilized:

Pet Medical Questions:

Has your pet ever received blood transfusion?

Has your pet shown signs of aggression towards people or other dogs?

Owner's Consent

I have agreed that my pet may participate as a blood donor in the Kimberley Veterinary Clinic Blood Bank donor program. Procedure: Your dog will be placed on a table and will be positioned on his side by an experienced veterinary nurse or veterinarian. A small area on his or her neck will be shaved. The area will be cleaned with a sterile prep solution. A sterile, single-use blood collection kit will be used for blood collection. A needle will be placed into the neck. Depending upon the weight of your dog, up to 450ml will be drawn (for dogs 20/25 kg and above). The needle will be removed from the vein and pressure will be applied to the site for several minutes. The procedure is generally completed in 5-10 minutes. If necessary, sedatives may be given to ensure that this is a safe and comfortable procedure for your pet. Benefits: The direct benefits to your pet include a comprehensive annual screening including both general blood work and blood-borne disease screening. This blood work will be made available to you upon your request. All testing is performed at no cost to you. Hill’s has agreed to sponsor any bag of food for every donation made by the donor! Indirect benefits to you and your pet include the satisfaction of helping save the lives of animals in need of blood products. The most common risks associated with blood donation are bruising or swelling at the site where blood was collected from. These problems are self-limiting and pose no serious harm to your pet. It is also possible that your animal may experience re-bleeding at the site. The likelihood of this can be reduced by not using a leash on your dog’s collar for the rest of the day of the donation. If such bleeding occurs, it will generally stop in a short time with the application of direct pressure and is not life-threatening if your dog does not have any existing clotting disorder. In rare circumstances, animals may experience a bit of “wooziness,” usually as the result of losing blood volume from a donation. Your animal will be given fluids to drink or intravenous fluids if this happens; with prompt treatment there is minimal risk of harm to your pet. Voluntary Donation Status: We are extremely grateful for you and your pet’s participation in our donor program. However, you are free to withdraw at any time and there is no penalty to you for doing so. Blood results of your pet will always be available to you at no cost.

I hereby have read the above paragraph and give consent for my dog (as mentioned above) to be a blood donor.

Upload a Picture/s of your Dog (optional, but we like to see them pets 🙂 )

Max. size: 256.0 MB

This deems as full indemnity to the Directors: Dr. D. Smith, CC Number: 2011/071557/23, VAT Number: 4660260094, SAVC Number: FCL00/4390

0
    0
    Your Cart
    Your cart is emptyReturn to Shop
    Verified by MonsterInsights