I hereby certify that I am the owner or duly authorized agent for the owner of the animal described above, and am of 19 years of age or over.

I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about these risks with the attending doctor before the procedure(s) is/are initiated. I understand that during the performance of the foregoing procedure(s) or operation(s), unseen conditions may be revealed that necessitate an extension of the foregoing procedure(s) or operation(s) that are set forth above. Therefore, I hereby consent to and authorize the performance of such procedure(s) or operation(s) as are necessary and desirable in the exercise of the veterinarian's professional judgment. I also authorize the use of appropriate anesthetics and other medications, and I understand that hospital support personnel will be employed as deemed necessary by the veterinarian.

I have been advised as to the nature of the procedures or operations and the risks involved, including the unfortunate possibility of complications causing death. I have had the tentitive or final diagnosis explained to me. as well as any reasonable alternative course of action (if any) and risks/benifits of each. I realize that no guarantee can be made legally or ethically to me regarding the outcome of any procedure performed. I have carefully read and do fully understand this authorization and consent.

Under legislation where there are no suitable medicines specifically authorized for the treatment of a particular species or a particular medical condition in that species, a medicinal product authorized for a different medical condition, or for use in another animal species or in humans may be used for the treatment of your animal. Such products will be used only when we consider them to be the most appropriate treatment.

The risks inherent in the procedures, treatments and anesthetics have been thoroughly explained and I accept those risks, including anesthesia mortality (0.1%) or infection (5%).