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P. 3285
• You understand what will be done to your pet during the
procedure
• You understand the known risks that accompany the procedure,
and also understand that unforeseen complications may occur
VetBooks.ir • You understand the alternatives to this procedure for your pet
• You understand that the procedure may not produce the results
we hope to achieve
• You agree that you have been given time to ask questions regard-
ing the procedure, that these have been answered satisfactorily,
and that you are free to decline the procedure.
____________________________________ ______________ Practice Stamp or Name & Address
Signature of pet owner/owner’s agent Date
____________________________________ ______________
Witness to consent (signature) Date
____________________________________
Witness to consent (printed name)
Also available in Spanish.
From Cohn and Côté: Clinical Veterinary Advisor, 4th edition. Copyright © 2020 by Elsevier Inc. All rights reserved.