Free · Unbranded · Consent & legal
A one-page record of what the owner wants if their pet’s heart or breathing stops in hospital: full CPR, a limited attempt, or do not resuscitate. It takes the decision out of the emergency itself, where there is no time to ask.
Unbranded: no logo or linksNo account neededPrint at 100% on US LetterUpdated
What’s on the form
Owner contact details and the patient, with the date and the attending veterinarian.
A plain description of resuscitation, how often it succeeds in general terms, and that it may lead to intensive care.
Full CPR, limited resuscitation (for example closed chest only, or a time limit), or do not resuscitate.
The estimated cost range of CPR and aftercare, written in before the owner decides.
Owner and veterinarian signatures, plus a short strip to copy onto the cage card or treatment sheet.
Fill in online
Every line on the form is editable right here. When you’re done, print it or choose “Save as PDF” in the print dialog. Everything stays in your browser.
Click any line to type, or add your logo. Nothing is uploaded or saved.
Using it well
Asking every owner, in the same calm way, normalizes the question. It is far harder to ask for the first time when a patient is crashing.
Survival after cardiac arrest is low in dogs and cats. Owners make better decisions when they hear that before they choose.
Copy the status to the cage card and treatment sheet. A decision that only lives in a folder will not be seen in time.
Printing, editing, and what the form does and doesn’t cover.
Do not resuscitate. If the pet’s heart or breathing stops, the team will not perform CPR. Other treatment continues unless the owner decides otherwise.
A middle option some hospitals offer, for example closed-chest CPR only, no open-chest CPR, or stopping after a set time. Write exactly what was agreed on the form.
Survival to discharge after cardiac arrest is low, generally reported in single digits to low double digits as a percentage, and depends heavily on the cause and how quickly CPR starts. Your veterinarian can explain what to expect for your pet.
Yes, at any time. Note the change, the time, and who took the call, and update the cage card.
1 page, US Letter, portrait
A code sheet the recorder can keep up with while CPR is running. Team roles at the top, then one line per two-minute cycle for rhythm, compressor, drugs, shocks, and EtCO2, and the outcome at the bottom.
2 pages, US Letter, portrait
An admission consent form for anesthesia and surgery. It captures the procedure and estimate, fasting and medications, the client’s decisions on bloodwork, fluids and resuscitation, and what to do if something unexpected is found.
2 pages, US Letter, landscape
A 24-hour flowsheet for hospitalized patients. Orders down the side, the clock across the top, so every treatment due and given is visible at a glance, with a second page for monitoring, fluids, and shift handover.
A starting point, not legal or clinical advice. VetStack’s forms are general templates. Requirements for medical records, consent, and controlled substances vary by state and practice, so review the wording with your practice’s attorney and check your state veterinary board’s rules before adopting a form as standard.