I, the undersigned owner or agent of the owner of the pet identified above certify that I am eighteen years of age or over. *

I consent to the examination of this pet by staff veterinarians at Prince William Animal Hospital. I also agree that after consultation with me, the hospital’s doctors may prescribe medication for, treat, hospitalize, sedate, anesthetize, and/or perform surgery on my pet. *

I understand that some risks always exist with anesthesia and/or surgery and that I am encouraged to discuss any concerns I have about those risks with the attending veterinarian before the procedure is initiated. Should unexpected life-saving emergency care be required and the attending veterinarian is unable to reach me, the hospital staff has my permission to permission to provide such treatment, and I agree to pay for such care. *

I understand that an estimate of the fees for veterinary services may be provided to me and that I am encouraged to discuss all fees related to such care before services are rendered and during my pet’s ongoing medical treatment. If my pet is hospitalized, I agree to assume financial responsibility for the fees and will provide payment via cash, credit card, or check at the time my pet is discharged from the hospital. *

In the event that my pet is hospitalized for more than forty-eight (48) hours and the attending doctor is unable to reach me, I understand it is my responsibility to call the hospital at least every forty-eight (48) hours to inquire as to the medical status of my pet and the fees incurred for medical services up to that day. *

I understand that veterinary care from closing time until opening the following day, and after closing Saturday to opening Monday is provided at the discretion of the attending veterinarian. There is not continuous presence of personnel during these hours. *