CAT Program Desexing Consent Form
Please enable JavaScript in your browser to complete this form.

Client Details

Name
Address

Pet Details

Sex
Check all that apply:
Reason for visit:
Has your Pet been Fasted for Surgery?

Consent

I am over the age of 18 years and am the owner or agent for the owner of the above-described animal and have the authority to execute this consent.

I hereby authorize AWLQ Inc. to perform all procedures as recorded on this form. I understand that during the performance of the procedures, unseen conditions may be revealed that necessitate an extension of the procedure. Therefore, I hereby consent to and authorize the performance of such procedures as are necessary and desirable in the exercise of the veterinarian's professional judgement.

I understand that these procedures may be performed by (and/or under the supervision of) any qualified member of our staff.

I assume financial responsibility for charges incurred to the patient.

I am aware that my pet is scheduled for a procedure that requires anaesthesia / sedation. I understand that although all reasonable precautions and due care will be taken; there is always a potential risk with any medical/surgical procedure, including death. I accept these risks and authorise AWLQ Inc. to perform such
treatment as deemed necessary.

I acknowledge that the AWLQ Inc. takes careful measures that patients at the clinic will not be exposed to contagious illnesses whilst they are on the premises. I recognize that if my pet is affected by contagious disease while at the clinic and my pet does not have a current vaccination history I am financially responsible for costs of treatment.

I will ensure that I am able to respond to the phone number provided throughout my cat’s stay at the clinic.

consent
My signature on this form indicates that any questions I have, have been answered to my satisfaction and I consent for the treatments/procedures to go ahead.
Clear Signature