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Surgical and Treatment Consent Form

Owner’s Name
Address
Type

Carefully read the following before signing your name

I understand that Preoperative blood work is highly recommended for animals over 5 years of age.

I, acting as owner or agent of the pet named above, hereby request and authorize ASAP, through whomever veterinarians they may designate, to perform an operation for surgical sterilization or other medical treatment of the animal named on the above portion of this form.

I understand that the operation presents some hazards and that injury to or death of such an animal may be a conceivable result, for there is some risk in the procedure and the use of anesthetics and drugs in providing this service.I understand that ASAP may not perform a complete physical examination before surgery is performed. I certify that my animal is in good health and has had no food since 12:00AM, the evening prior to surgery (Cats and dogs).

I understand that some factors significantly increase surgical risk, including but not limited to, pregnancy, estrus (heat), and diseases such as feline immunodeficiency viral infection (FIV), feline leukemia viral infection (FeLV), and heartworms,brachycephalic dogs, and obesity. I understand that if my animal is pregnant, the pregnancy will be terminated at surgery.

I understand that ASAP does their best to text or call prior to added services, but if we cannot get ahold of someone, ASAP will proceed.

I Understand that my pet must be up to date with vaccines at the time of surgery or treatment. I understand that if my pet is not vaccinated, they will be vaccinated at my own expense. I understand that ASAP is not liable if my pet is exposed to illness at the time of surgery or treatment. I understand that if fleas and/ or parasites such as worms are visible at the time of Surgery or treatment, ASAP will automatically provide flea and/ or antiparasitic treatment at my own expense.

I hereby release the Amazing Small Animal Practice, all veterinarians, assistants, volunteers, directors, and employees from any and all claims arising out of or connected with the performance of this procedure or any adverse reactions from vaccinations or medications. I agree that I have not and will not claim any right of compensation from them, or any of them, or file action by reason of such sterilization, attempted sterilization, or medical treatment of such animal or any consequences related thereto. Owner/agent hereby agrees to indemnify and hold ASAP harmless for any damages caused during the transportation of the animal, or for any damages caused by any unforeseeable events including fire, vandalism,

Please Check All Services Needed

Requested Vaccines and Services
Spay/Neuter and Other Services
NOTICE: These prices are for standard spay and neuters only and do not reflect extra charges if the pet is in heat, pregnant, postpartum, cryptorchid, umbilical hernia or needs puppy teeth/ dewclaws removed at the time of surgery.
(Prices vary depending on extractions needed)
(Required for all sterilizations, except Feral Cats)
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