Release Form

Please fill out the form below:

  • I agree to hold the Animal Care Clinic harmless, in the absence of negligence, in the event of untoward anesthetic complications that might have been detected had these tests been performed.
  • I hereby authorize the veterinarian of the Animal Care Clinic to examine my pet(s), and prescribe for, hospitalize, anesthetize, or perform surgery on the above-mentioned animal(s). I understand that during the performance of this/these procedures, unforeseen conditions may be revealed that necessitate an extension or variance in the procedure(s) set forth above. I expect reasonable care and judgment in performing the procedure(s). The nature of the procedure(s) and risks involved has been explained to me and I realize results cannot be guaranteed. I am also aware that unforeseen events resulting from the procedure(s) will not relieve me from any obligation to all reasonable costs incurred regarding this/these animal(s). I, the undersigned, whether or not the owner, assume financial responsibility for ALL services rendered, including those deemed necessary for medical or surgical complications or otherwise unforeseen circumstances.