I, the above-signed owner (or owner's agent) of the animal described above, hereby authorize the medical and/or surgical procedures(s) listed on the above titled document. I have been advised as to the nature of the procedure(s) and have been encouraged to discuss any concerns I may have.

For patients being admitted for surgery, I understand that routine blood tests will be performed prior to anesthesia to detect problems that may not show up during a routine physical examination; however, I realize that there can always be rare complications associated with any anesthetic or surgical procedure. As a result, I am aware that no guarantee regarding results, cure or safety can be made ethically or professionally. I fully understand these risks and understand that the veterinarians and hospital staff will try to minimize such risks; however, I will not hold Mount Laurel Animal Hospital, the veterinarians or any staff member liable for any complications that may arise. We attempt to contact clients following conclusion of surgical procedures, however the caseload of the hospital may not always make this practical; therefore, in order to obtain an update on our pet's status, we encourage all clients to contact the hospital between 6 and 8 hours after your pet has bee admitted for surgery. I understand that an estimate cost for the veterinary service will be provided to me upon my request. I am encouraged to discuss all fees related to such care before services are rendered and during my pet's stay.