I verify I am the Owner (or Authorized agent for the owner, at least 18 years or older) of the above named animal and authorize the above procedure to be performed. I authorize the use of sedation, anesthesia and other medication as deemed necessary by the veterinarian and understand that hospital personnel will be employed in the procedure(s) as directed by the veterinarian. I have been advised as to the nature of this procedure to be performed and the risks involved. I understand also that there is always a risk associated with any sedation or anesthesia episode, even in apparently healthy animals and have discussed my concerns with the veterinarian. While I accept that all procedures will be performed to the best of the abilities of the veterinarians and staff at this hospital, I understand that no guarantee or warranty has been made
regarding the results that may be achieved. I understand that any estimates provided for such procedures are for noncomplicated procedures and that any unforeseen complications may result in additional costs. I understand that it may be necessary to provide medical and/or surgical intervention which were not anticipated for the safety or care of my pet. I hereby consent to and authorize the performance of such altered and/or additional procedures as are necessary in the veterinarian’s professional judgment. I accept responsibility for any result in additional charges. I agree to be responsible for any charges incurred while my pet is in the care of this facility and understand payment is due at the time my pet is
released from the hospital. I understand no staff will be attending to my pet overnight (pets needing special care may be
referred to a 24 hour hospital).