I, the undersigned, certify that I am the owner, or authorized agent for the owner, of the animal described above. I authorize the doctor on duty and assistants to perform the procedures listed above and on the attached estimate. Such procedures will include administration of pain relief medications, sedatives or anesthetics, as well as any necessary and appropriate medical, radiological, surgical, nursing, diagnostics, and/or emergency care for the animal.
Anesthetic complications- Reaction to medication, Death
Surgical complications which affect the outcome of the procedure
Please provide the best phone numbers to reach you at in case of emergencies and for updates regarding your pet.