Canine Surgical Release Form

Your pet is being admitted for surgery at Metz Petz Veterinary Clinic. To minimize the likelihood of complications during anesthesia, we recommend that you pet receive a pre-anesthetic blood screen to detect potential health problems. All patients are required to have a Prep Panel completed prior to surgery. All patients are also required to go home with some sort of pain medication, this is included in your estimate.

* If your pet has fleas (s)he will be treated at an additional cost to you.

I authorize the doctor(s) at Metz Petz Veterinary Clinic to perform the above anesthetic and surgical procedure(s) described above. I understand that some risks exist with anesthesia and/or surgery and I am encouraged to discuss and concerns that I may have. I further understand that unforeseen conditions may require an extension of the planned procedure(s) and I authorize the performance of additional treatment.

While I understand that all procedures will be performed to the best of the abilities of the staff at Metz Petz Veterinary Clinic, I understand that there is no guarantee or warranty regarding the results that may be achieved.

I agree to assume full financial responsibility for all charges incurred in the care of this animal. I also understand that Metz Petz Veterinary Clinic does not have a payment policy and that all charges will be paid in full at the time of release. I have read and full understand the terms and conditions set forth above.