Sterilization and Medical Care Authorization
I, the undersigned, have read and understand this entire page and authorize Central Oregon Veterinary Express [“COVE”] to anesthetize, surgically sterilize, and provide other related medical care [“Procedure”] to the cats I registered above for services. I agree to pay according to the fee schedule provided by COVE for the Procedure.
I understand there are medical risks associated with the Procedure, including but not limited to infection, hemorrhage, allergic reaction, anaphylaxis, injection site sarcomas, anesthetic drug reaction, anesthesia-induced cardiac compromise, and death. I understand that Central Oregon Veterinary Express will perform a physical exam if my cat's behavior allows but will not perform a comprehensive cardiac exam, other diagnostic tests, and blood-work prior to the Procedure. I understand that there are increased risks due to the fact that COVE will not perform extensive pre-operative diagnostic evaluations. I understand that some factors significantly increase surgical risk, including but not limited to, pregnancy, being in heat, and diseases such as Feline Immunodeficiency Virus (FIV), Feline Leukemia, and heartworm disease. I understand that if my pet has a pre-existing medical condition, clinical or subclinical, this condition may be worsened by anesthesia and/or surgical sterilization. I further understand that there are additional risks if the cat is not current on recommended vaccines.
I will hold harmless COVE, its officers, directors, veterinarians, technicians, volunteers, and agents for any problems experienced by the animal as a result of the Procedure or the above risk factors. I further agree to hold harmless the host that has allowed use of their facilities for the Procedure.
If in the course of treatment a condition is discovered that requires medical attention or an additional procedure, such as hernia repair or the administration of IV fluids, the attending veterinarian may, in his/her absolute discretion, perform such procedure. I consent to these procedures and agree to pay reasonable additional charges if any.
I agree that I will be available by phone the day of the Procedure. If a situation arises and I cannot be reached at the phone number provided, I authorize the veterinarian to use his/her discretion and clinical judgment as to how to proceed. I understand that the COVE staff will not leave a message, and that I have to be available by phone during the day of the Procedure. My phone number for the day has been provided above.
I certify that my animal will not be given food after 12:00 midnight the evening prior to surgery (excluding pets less than 4 months old). I understand that my cat will receive a small permanent green line tattoo on the abdomen or a tipped ear if feral to indicate sterilization.
I agree that I will be financially responsible for any post-operative medical treatment relating to this Procedure or any other unrelated medical problems of my animal. I grant COVE, its representatives and employees the right to take photographs and/or video of my cats while at the clinic for surgery. I agree that COVE may use such photographs and/or video of my cats for any lawful purpose, including for example such purposes as publicity, illustration, advertising, and web content. By electronically signing my name below and submitting this form, I confirm that I have read and agree to the terms of this consent.