14.6. HQ's Surgical High Risk Waiver Template
Surgical High-Risk Waiver Template Overview.
The Surgical High-Risk Waiver template is generated from concerns identified during a physical exam.
The emailed template allows the client to review the concern and choose whether to accept or decline the surgery.
This waiver is not available to send before an appointment for known pre-existing conditions.
Download HQ Recommended Templates
High-Risk Waiver Template Structure.
A well-designed high-risk waiver form includes the following components.
- Animal and owner information such as the owner’s address and an animal description.
- Instructions on declining the waiver so the client understands how to decline surgery.
- The explanation of high-risk concern, which documents why the animal is considered high risk.
- The HRWReasons merge field populates based on the concern selected during the exam.
- Reasons are pulled from pre-written blurbs in Settings > Medical Notes > High-Risk Waiver Triggered Notes.
- Learn how to configure these reasons or use the ASPCA-provided examples here: HERE.
#_ Terms of agreement outlining the client’s acknowledgment of increased surgical risk and that there is no guarantee of a successful outcome.
Additional Resources.
Read more about managing high-risk waivers in Patient Flow HERE
Best Practice Guidance.
✅ Pro Tip: If your clinic uses electronic consent for high-risk waivers, use the HQ recommended template to ensure successful delivery. The template is specifically structured to support the HRW Reason merge field within a fixed table and clearly explains how clients can decline the waiver.