I, the undersigned owner or agent of the pet identified above, authorize the staff of {Atlas Pet Hospital} to
perform the above procedure(s).
I understand that some risks always exist with Anesthesia/ Sedation and/ or surgery/ Services mentioned
above. The nature of the above services has been discussed with me to my satisfcation and I assume full
responsibilty for the treatment expenses involved/ and I will not hold Atlas Pet Hospital or its staff,
responsible under any circumstance
I have read and fully understand the terms and conditions set forth above.