The information provided on this form is true to the best of knowledge. I verify that I am the owner (or Authorized agent for the owner) of above named pet and authorize the above procedure to be performed. I authorize the use of anesthesia and other medications as deemed necessary by the veterinarian and understand the 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 anesthesia episode, even in apparently healthy animals and have discussed my concerns with the veterinarian. I understand that it may be necessary to provide medical and/or surgical procedures which are not anticipated for the safety or care of my pet. I herby consent to and authorize the performance of such altered and/or additional procedures as are necessary in the veterinarian's professional judgement. 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
