I, being responsible for the described animal on this form, have the authority to grant my consent to receive, prescribe for, treat and/or provide surgical/medical procedures on this animal.
I hereby give my consent for this patient to receive medical treatment by Piedmont Equine Associates, Inc.
- Piedmont Equine will use all reasonable precautions against injury, escape or death, but will not be held liable or responsible in any manner in connections therewith as it is thoroughly understood that I assume all risks. I understand that this treatment/operation is necessary, its advantages, possible complications, and possible alternative modes of treatment have been discussed with me. I understand that further procedures may be therapeutically necessary based on findings during the procedure/surgery, I consent to those procedures, their additional cost, and any unexpected lifesaving emergency care deemed necessary by the attending veterinarian.
- I authorize the use of appropriate sedation and/or medications. I understand that risks and potential complications exist with anesthesia that could involve serious bodily injury, loss of pregnancy or death.
- I understand during the performance of the foregoing procedure or operation, unforeseen conditions may be revealed that necessitate an extension of or different procedures. I hereby consent to and authorize the performance of such procedures or operation as deemed necessary and advisable in the professional judgement of the veterinarian.
- I agree to care, custody and handling of my horse by Piedmont Equine Associates. I acknowledge that any inpatient horse is at risk of exposure to pathogens or infectious disease. I acknowledge that Piedmont Equine Associates utilizes measures to prevent such occurrence and hold them harmless against any and all liability attached.