Anesthesia/Surgery Authorization
I am the owner of the above-named animal or am responsible for it and have authority to execute this consent.
I hereby authorize Shaffer Animal Hospital to perform the above procedure(s). I hereby also authorize the use of such anesthetics as you see advisable and performance of such surgical or therapeutic procedures as you determine to be indicated. I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure(s) is/are initiated. My signature of this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:
- The reasonable medical and/or surgical treatment options for my pet
- Sufficient details of the procedures to understand what will be performed
- How fully my pet will recover and how long it will take
- The most common and serious complications
- The length and type of follow-up care and home restraint required
- The estimate of the fees for all services Any necessary payment arrangements
I understand that if I pick up my pet any later than the posted time of closure of the business, I may be subject to a late fee of $10 per 15 minutes.
While I accept that all procedures will be performed to the best of the abilities of SAH, I understand that veterinary medicine is not an exact science and that no guarantee or warranty has been made regarding the results that may be achieved. I agree to indemnify and hold harmless from and against any and all liability arising out of the performance of any procedures referred to above.
I agree to pay a deposit of 50% of the estimated fees, assume financial responsibility for the remaining fees due on the date of discharge, and provide payment via cash, accepted credit cards, Scratchpay, or check at the end time my pet is discharged from the hospital.