Cat’s NameD.O.B. / AgeProcedure I am the owner or agent of the above cat(s). I have the authority to execute this consent and am over the age of 18. I hereby authorize Dr. Flynn at The Cat Clinic of Destin to administer anesthesia for the stated procedure or surgery. I understand that a very safe anesthesia will be administered and my cat will be monitored throughout the procedure until he or she recovers. I understand that all anesthetics and surgical procedures have certain risk involved and that every precaution will be taken to minimize risks. I understand that no guarantee exists as to the results of diagnosis and treatment of said cat. If fleas or flea debris are found on my cat, I understand that he or she will be treated as deemed necessary by Dr. Flynn at my expense. I understand that all cats brought in to the clinic must be up to date on all required vaccinations. If I cannot provide proof that my cat has a current Rabies vaccination, he or she will be brought up to date while in the hospital today, according to state law. Current MedicationsYesNoPlease listMicrochip Identification:YesNo(Very few lost cats find their way home without permanant ID. We can implant this while sedated.)Please initialPre-Anesthetic Blood work:YesNo(Recommended to screen your pet for any illnesses that may complicate anesthesia.)Please initialSignatureDate Date Format: MM slash DD slash YYYY Chart Number (clinic use)CAPTCHA
