I, the undersigned, certify that I am the owner, or an authorized agent for the owner, of the above-described animal. I authorize the doctor on duty and assistants to perform the procedures listed above, including the administration of pain relief medications, sedatives, and/or anesthetics, as well as any necessary and appropriate medical, radiology, surgical, nursing, diagnostic, and/or emergency care for the animal. I have been advised as to the nature of the procedures and the potential risks and understand that no guarantee of successful treatment can be made. I have been informed and am clear in my understanding of the fees associated with services to be performed.
All surgery patients are administered pain injections. Spay/neuter certificates do not cover the cost of these injections; they will be the responsibility of the owner. (Cost is approximately $30.00-$40.00). Pain injections will be administered at the discretion of the doctor.
I have read and understand the reasons for and the risks of the above and attached authorized procedure(s), and assume full responsibility for all charges and services incurred to the described animal. I understand that in the event of anesthetic complications or if emergency medications must be administered, additional charges could be incurred.