I hereby authorize Dr. Fontanez of Portland Veterinary Hospital to perform the above stated procedures, as well as any other treatment that they deem necessary for the health and well-being of my pet while under their care. I understand that I will be informed of any changes in the estimated fees due to unforeseen circumstances. The nature of the procedure has been explained to me and No guarantee has been made as to the results or cur. I understand that there are always risks involved with any surgery or anesthetic protocol, but that precautions will be taken to minimize risks involved with any surgery or anesthetic protocol, but that precautions will be taken to minimize risks as much as possible. I understand that my pet will be released during office hours only, and that Full PAYMENT IS REQUIRED UPON RELEASE OF MY PET.

I understand that should my pet injure itself in an attempt to escape, refuse food, suddenly become ill and die, or succumb to the effects of natural disasters (Hurricanes, Lightening, Tornadoes), I cannot hold Portland Veterinary Hospital liable in the absence of gross negligence as provided by state law.