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Skyline Animal Hospital

surgery release form

Get started on filling out our surgery form by clicking the button below! We look forward to seeing you.

skyline animal hospital SURGERY RELEASE form

Please fill out the form below as accurately as possible. Thank you.

Release

I, certify that I am the owner of the pet mentioned above (or duly authorized agent for the owner) and hereby give the veterinarian at Skyline Animal Hospital, their agents, staff and/or representatives full and complete authority to perform the surgical procedure described : I do hereby release the said Doctor, her agents, or representatives from any and all liability arising from said surgery on pet listed above. I assume full responsibility for all charges incurred in the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I understand that Pre-operative blood work is mandatory for all pets undergoing anesthesia. This test assists us in evaluating your pet’s health to be certain your pet may process the anesthesia without complications.