Authorization for Surgical Procedure:
This estimate is not a firm quote and as such is subject to change due to unforeseen circumstances. We will make every effort to inform you should your pet's changing condition require substantial procedures or diagnostic work not outlined in the above estimate.
- I am the owner or an authorized agent for the owner, and I have the authority to execute the consent.
- This estimate is valid for 30 days from the above date.
- I understand that payment is due in full upon discharge of the animal.
- I understand that this is an Estimate, and that during the course of the procedures, including routine procedures, unforeseen conditions may arise that necessitate the performance of additional costs. I understand that all efforts will be made to contact me before exceeding the estimate.
- I am aware that Canine spay and neuter procedure prices are based on the weight of my pet at the time of surgery.
- I expect Valley Animal Hospital to use reasonable care and judgment in performing the procedure. By signing below, I do hereby forever release the said doctors, his or her agents, servants, or representatives from any and all liability arising from the said procedure(s) on the said animal. The nature of these surgeries or procedures has been explained to me, and I understand the risks and potential complications involved with surgery.
I have read, understand, and accept the estimate and terms above Owner (or agent of the owner)
I authorize Valley Animal Hospital to treat my pet with Capstar if fleas are found and I (owner) will be responsible for the $10.00 charge. (This is required for all surgery procedures. This keeps our hospital flea free and our patients protected.)
