Consent for Treatment
I, the undersigned person, declare that I am over the age of eighteen (18), and that I am legally responsible for the welfare of the below-identified pet, and I give my permission to Rozzie May Animal Alliance (RMAA) to hospitalize this pet.
During hospitalization, I understand that the staff of RMAA may administer vaccines, medications and anesthetic agents as well as perform surgical procedures and other treatments that they deem necessary for the health, safety and well-being of my pet while under their care and supervision. I also understand that the veterinarian will perform a brief physical examination prior to surgery to better determine if this pet is a healthy candidate for surgery. I further understand that if a heart murmur is heard, it will be up to the veterinarian’s medical judgment as to whether to proceed with anesthesia and surgery.
If the veterinarian is unable to perform a pre-anesthetic exam due to the behavior of my pet, making it not possible to adequately assess the anesthetic risk, I consent to him/her proceeding with anesthesia and surgery, understanding that there might be an increased risk of complications.
I understand that there are inherent risks associated with anesthetic, medical and surgical procedures, including death. I authorize the doctors and staff of RMAA to address these complications should they arise while under their care. In the event of an emergency, the clinic will make every reasonable attempt to contact me to make me aware of the situation so that I can be involved in medical decisions. The contact phone numbers in the chart are correct.
I agree that I will hold harmless RMAA, its directors and officers, veterinarians, animal care technicians, drivers, volunteers and agents regarding any unforeseen complications associated with the surgery or post-surgical period as well as any transport services.
If we determine that a pet is pregnant, the surgery will be performed, resulting in termination of the pregnancy and humane death of the fetuses. If, however, the veterinarian chooses not to perform the surgery for the safety of the pet, he/she reserves the right not to proceed. There will be an increased fee associated with the spaying of a pregnant pet, the amount of which will be determined by the doctor based upon the increased amount of time involved.
I further realize that I am responsible for payment for all of the above-mentioned procedures, treatments and surgeries in full at the time my pet is discharged, including any additional services that are deemed necessary.
I understand that RMAA is not responsible for providing any further post-surgical medical treatment or treatment for any medical emergencies. If these services are deemed necessary, it is my responsibility to transport my pet and to pay for any emergency care, treatment and monitorin