I am the owner of the above named animal or am responsible for it and have the authority to execute this consent form.

I hereby authorize Animal Health & Medical Center to perform such diagnostic, therapeutic, anesthetic and surgical procedures as are necessary and advisable for the treatment and maintenance of my pet’s health.

• While I expect all procedures to be done to the best of the abilities of the professional staff, I realize that no guarantee or warranty can ethically or professionally be made regarding the result or cure.
• In the event that my animal should, for some unforeseen reason, injure itself, escape, fail to eat, become ill or die, I will not hold Animal Health & Medical Center and/or its employees responsible.
• I expect that reasonable precautions will be used to insure the animal’s safety and well-being while in the clinic’s care and agree to pay in full for all services and products at the time of discharge.
• If unforeseen needs arise that have not been discussed and I cannot be reached for approval, I accept the doctors’ decision to proceed with that which is necessary.

By agreeing below, I also give my permission and agree to pay for parasite control to be administered if my pet is found to be carrying any parasites (including fleas, ticks or ear mites).

This screening is not a guarantee against problems or complications, but it will help us deal with a problem, should it arise, or avoid the procedure altogether until a discovered problem can be corrected.