Cumming Veterinary Clinic
"Where we treat every pet as our own"
I, the undersigned owner or agent of the owner of the pet identified above, certify that I am eighteen years of age or over and authorize the veterinarians(s) at Cumming Veterinary Clinic to perform the above procedure(s). I understand that some risk always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have with about those risks with the attending veterinarian before the procedure(s) is/are initiated. My signature on this form indicate that any questions I have regarding the following issues have been answered to my satisfaction:
4110 Deputy Bill Cantrell Memorial Road
Cumming, GA 30040
770-887-3119
Thank you for entrusting us with the care of your pets.