I am the owner, or agent of the owner, of the above animal and have the authority to execute this consent. I hereby consent and authorize the performance of the above named procedure(s) or surgery(s). I also authorize the use of appropriate anesthetics, and other medications as deemed necessary by the veterinarian. I have been advised as to the nature of the procedure(s) or surgery(s) and the risks involved. I understand the above anesthetic and surgical, diagnostic or therapeutic procedures may involve risk of complications, injury or even death, from both known and unknown causes and no warranty or guarantee has been either expressed or implied as to result or cure.
I also assume full responsibility for any additional expenses incurred after the surgical procedure is performed, such as follow up radiographs, re-check physical exams and additional surgery due to post-op complications. These are more likely to occur when there is a failure to comply with the aftercare instructions.
Furthermore, I authorize the hospital staff in an emergency situation, to follow through with such procedures as are necessary for the well-being of my pet on a continuing basis until further communication with me. I agree to assume financial responsibility for all routine and emergency services rendered.
Your signature below constitutes your acknowledgment that (i) you have read and agreed to the above, (ii) the procedure(s) have been explained to your satisfaction and that you have all the information that you desire, (iii) you have had the chance to ask questions, and (iv) you authorize and consent to the performance of the procedure(s) and to the administration of anesthesia.