Surgical Check-In

I, the undersigned owner or agent of the owner of the pet identified above, certify that I am eighteen years of age or older and authorize Sharp Pet Hospital to perform the above procedures. I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure is to be initiated. My signature on this form indicates that any questions I have regarding the following issues have been answered to my satisfaction:

• The reasonable medical and/or surgical options for my pet
• Sufficient details of the procedures to understand what will be performed
• How fully my pet will recover and how long it will take
• The most common and serious complications
• The length and type of follow-up care and home restraint required
• The estimate of the fees for all services
• Any necessary payment arrangements

While I accept that all procedures will be performed to the best of the abilities of the staff at this hospital, I understand that no guarantee or warranty has been made regarding the results that may be achieved. I agree to financial responsibility for the remaining fees and will provide payment via cash or credit card at the time my pet is discharged from the hospital.