I certify that I am the legal owner, or duly authorized agent for the legal owner, of the animal listed above. I hereby give Animal Protectors of Allegheny Valley and any authorized agent/s, staff or representatives full and complete authority to sterilize, vaccinate and or microchip my pet.
I understand the risks involved in administration of general anesthesia, to any animal, known history or not, is inherent in the sterilization procedure, including death. I realize that the professional staff of Allegheny Protectors of Allegheny Valley will use every possible precaution to prevent anesthetic complications from occurring.
In the event of an emergency, Animal Protectors of Allegheny Valley will make every reasonable attempt to contact me so that I am aware of the situation, so that I am involved in medical decisions. The contact phone number(s) on this form are correct.
I understand that there are certain risks and complications associated with any operation or procedure of this type.
I authorize the use of pain relief medication as needed before, during or after the procedure.
I understand there are risks associated with the use of any medication.
I understand that modern techniques and trained staff will be used to care for all animals and reasonable. precautions will be used against injury, escape or destruction of the animal. It is thoroughly understood that Animal Protectors of Allegheny Valley, its staff, volunteers and agents will not be held liable or responsible in any manner and I assume all risks.
I further understand that as long as, in the opinion of the attending veterinarian, the animal is an acceptable surgical candidate, the sterilization procedure will occur.
Finally, by signing this document, I both understand that I am responsible for and agree to adhere to all Post Operative Care instructions as directed by Animal Protectors of Allegheny Valley. I understand that Animal Protectors of Allegheny Valley is not responsible for care or treatment provided after surgery which results
from failure to abide by the post-surgical guidelines and instructions.