Please read and understand the following:
1. I am the owner or appointed liaison of the patient indicated above and I am over the age of 18.
2. I understand that if the above named pet is found to have fleas a flea medication will be given at an additional cost to me.
3. I understand that in order for a procedure requiring anesthesia or sedation to be performed safely my pet will be shave and an intravenous catheter will be placed in my pet using aseptic technique. This is to ensure reliable venous access for the purposes of pain management, sedation, antibiotic therapy, fluid support and possible emergency intervention.
4. I accept that an initial medical treatment plan will be reviewed with me by a veterinary technician where the medical and financial aspects of this anticipated treatment plan will be agreed upon prior to admission of my pet into the hospital for the above indicated procedure.
5. I agree to pay in full for services rendered while my pet is hospitalized prior to him/her being discharged. This includes any fees related to services deemed necessary for my pet in the occurrence of a medical/surgical emergency or change in medical therapy due to unforeseen circumstances.
6. If an emergency situation may occur and I am unreachable immediately at either of the above listed contact phone numbers I authorize the attending veterinarian to proceed with medical care under their judgment.
7. I acknowledge that no guarantees can be made regarding medical diagnosis, intervention, therapy and recovery plans pertaining to my pet except that all reasonable precautions against injury, escape, illness, and death will be taken while hospitalized.
8. I understand that there are risks associated with any procedure that requires anesthesia or sedation and I have spoken to the veterinarian regarding my concerns related to those risks that include, but are not limited to escape, injury, illness and death. I accept the risks associated with my decision to have the above indicated procedure performed on my pet. I do not hold Sacajawea Healthcare for Pets, its doctors, staff or associated entities responsible for any unforseen outcome related the procedure being performed on my pet today.