Please complete the following form allowing American Veterinary Hospital to perform a surgical procedure on your pet. We ask that you read the form in its entirety and acknowledge each statement. If you have questions or concerns regarding this form please contact our practice directly.
WOOF GANG RESCUE ADOPTED PETS ONLY
Please read the options below. The rescue does not cover the cost of these options and you would be financially responsible at the time of discharge should you choose to opt-in.
As the owner, or authorized agent of the above named animal, I hereby consent and authorize American Veterinary Hospital to receive, prescribe, treat, and operate on my pet. The nature of the procedure(s) being performed has been explained to me and no guarantee has been made as to the results or cure. I understand that the practice staff and doctors will make every effort possible to minimize the risk associated with general anesthesia and the services to be performed, however all risks will be assumed by me.
- I have read, fully understand, and agree to the above.
- I understand that all fees must be paid before my pet is released from the hospital.
- I understand a written estimate of anticipated fees has been or will be provided for me upon request.