Surgery Admission Form

I certify that I am the owner, or an authorized agent for the owner, of the above animal. I hereby consent to and authorize the doctors and staff at this veterinary practice to admit this pet, perform the above-described procedures, and administer medications, anesthesia, surgical procedures, tests, and or treatments that the doctors deem necessary for its health, safety, and well being while under their care and supervision. I have been advised of the nature of the procedures and the potential risks and benefits. I understand that veterinary medicine is an inexact science and that no guarantee of successful treatment can be made.

I understand that antibiotics (oral or injectable), pain medication (oral or injectable), and anti-inflammatory medication may be prescribed for my pet per the veterinarian's discretion. I also understand my pet must be free from both internal and external parasites while in the clinic. If parasites are found, my pet will be treated, and this will be at additional cost to the fees provided on the estimate.

I acknowledge that I am responsible for payment in full for the above procedures and treatments at the time my pet is
discharged.