Liability Discalimer Form DisclaimerOwner's NameAddress Street Address City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email I am the owner or the agent for the owner of the animal(s) described above, and I have the authority to execute this consent. I hereby consent and authorize Dr. Fernando Cardenas, Dr. Elaine Means, Dr. Tracy Tinsley, Dr. Erin Slaighter, Dr. Ashleigh Crowell or Dr. Candince Lorandeau to perform the following procedures or operations:The nature of these operations or procedures has been explained to me, and I understand what will be done. I have also been informed that there are certain risks and complications associated with any operation or procedure of this type. They have been explained to me as well. I further understand that during the course of the operation or procedures, unforeseen conditions may arise that may necessitate the performance of additional procedures. I authorize the use of appropriate anesthesia and pain relief medications as needed before or after the procedure. I have been informed that there are risks associated with the use of any medications. Electronic Signature of Client*Date* MM DD YYYY PhoneThis field is for validation purposes and should be left unchanged.
