• Owner Information

  • Pet Information

  • Consent and Release

  • I am the owner or the agent for the owner of the animal described above, and I have the authority to execute this consent. I hereby consent and authorize Dr. (principal veterinarian or owner)/staff to perform the following procedure or operation:
  • The nature of these operations or procedures has been explained to me, and I understand what will be done.

    I have also been informed that there are certain risks and complications associated with any operation or procedure of this type. They have been explained to me as well. I further understand that during the course of the operations or procedures of unforeseen conditions may arise that may necessitate the performance of additional procedures.

    I authorize the user of appropriate anesthesia and pain relief medication as needed before or after the procedure. I have been informed that there are risks associated with the use of any medication.

    I understand that hospital support personnel will be used as deemed necessary by the veterinarian.