Community Cat Consent

COMMUNITY CAT PROGRAM CONSENT FORM
Name

First Name Last Name
Address

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.
Email
example@example.com
Cat #1 Description: (color, gender, and estimated age): blanks .
Cat #2 Description: blank.
Cat #3 Description: blanks .
Cat #4 Description: blank
Please fill out a new form if you have more than 4 cats today
An appointment for services must be made by calling (307)271-5964 or emailing drwinsch@caswy.org.
COMMUNITY CAT PROGRAM TERMS AND ANESTHESIA CONSENT FORM.
The fee for the feral cat services is $40 per cat, payable by cash or credit card. This fee must be paid before the owner can pick up the cat(s). No personal checks are accepted.
Cat(s) must be dropped off at the Shelter between 8 am and 9 am on the day of scheduled surgery. Cat(s) may be picked up between 4:00 p.m. and 6:00 p.m. on the day of the surgery, unless other arrangements are made before or at the time the cat(s) are dropped off. Cat(s) not picked up as directed will be declared abandoned and will be handled as such
The Cheyenne Animal Shelter Veterinary Services does not have housing to be able to routinely house cats for longer than the day of surgery. Cats in traps can safely be housed in a garage/ barn/ bathroom (somewhere dry), covered with a towel, and newspapers or a tarp underneath for the night before, and the night after surgery. Cats can safely be released 24hrs after sx.
All feral cats will be spayed or neutered, left ear will be tipped, and receive FVRCP and Rabies vaccinations.
Cats must be over 3lbs and a minimum of 3 months old to qualify.
CONSENT AND ACKNOWLEDGEMENT OF RISKS
I agree to hold CAS and its employees or contractors harmless for any event or condition relating to the provision of veterinary services and care to the cat(s) I provide to the Shelter under this program.
I authorize the CAS veterinarian and CAS staff to anesthetize, vaccinate, test, perform surgery on the feral cat(s) I bring to the Shelter.
I understand there are potential risks associated with the services provided under this program, including infection, reaction to anesthesia, uncontrollable bleeding, and/or death.
I understand that, in the course of surgery, the veterinarian may diagnose or discover other conditions which may lead the veterinarian, at his or her discretion, to euthanize the cat(s) or otherwise modify the anticipated treatment of the cat(s). All attempts to contact the caretaker will be performed first.
I understand and agree that the treatment and care to be provided to the cat(s) are totally within the discretion of the CAS veterinarian, and that I will accept the veterinarian's judgement as to the appropriate care and treatment of the cat(s).
By signing below, I consent to Cheyenne Animal Shelter providing surgical services as described in this document to feral cat(s) which I bring to the Shelter, and I acknowledge the risks and possible outcomes of the services described above:
Signature

Clear
Additional services may be purchased to be performed at the time of surgery, please check any services below that you would like performed in addition to the services previously listed:

Microchip ($30.00)- recommended if caretaker wants to be able to be notified if cat gets picked up by an animal control officer or brought into the shelter by another patron Feline Leukemia/FIV test ($30.00). This test is only recommended if the caretaker wants to bring the cat in as a pet, rehome the cat as a pet,or wants the cat euthanized if positive for one of these disease Feline Leukemia Vaccine ($5.00). A booster vaccine is recommended in 3-4 weeks for this vaccine to be most effective. Again, only recommended if the patron intends to keep the cat as a pet cat.
Should be Empty:

An appointment for services must be made by calling (307)271-5964 or emailing drwinsch@caswy.org.

COMMUNITY CAT PROGRAM TERMS AND ANESTHESIA CONSENT FORM.

The fee for the feral cat services is $40 per cat, payable by cash or credit card. This fee must be paid before the owner can pick up the cat(s). No personal checks are accepted.

All feral cats will be spayed or neutered, left ear will be tipped, and receive FVRCP and Rabies vaccinations.

Cats must be over 3lbs and a minimum of 3 months old to qualify.

CONSENT AND ACKNOWLEDGEMENT OF RISKS

I agree to hold CAS and its employees or contractors harmless for any event or condition relating to the provision of veterinary services and care to the cat(s) I provide to the Shelter under this program.

I authorize the CAS veterinarian and CAS staff to anesthetize, vaccinate, test, perform surgery on the feral cat(s) I bring to the Shelter.

I understand there are potential risks associated with the services provided under this program, including infection, reaction to anesthesia, uncontrollable bleeding, and/or death.

I understand and agree that the treatment and care to be provided to the cat(s) are totally within the discretion of the CAS veterinarian, and that I will accept the veterinarian's judgement as to the appropriate care and treatment of the cat(s).

By signing below, I consent to Cheyenne Animal Shelter providing surgical services as described in this document to feral cat(s) which I bring to the Shelter, and I acknowledge the risks and possible outcomes of the services described above: