• Date Format: MM slash DD slash YYYY


  • I hereby certify that I am the owner or the owner’s agent of the above named cat and have the authority to authorize the above named procedure(s), the performance of which are hereby authorized. As part of the named procedure(s), I consent to blood and/or tissue sampling, medically diagnostic or photographic imaging, or other reasonable and non-harmful testing that may be of educational or investigational value to my cat or to other cats.

    I recognize that the above listed procedure(s) carry a small but realistic possibility of complications and side-effects that may include death. I agree to hold the staff of Alamo Feline Health Center blameless for all complications in the absence of gross malpractice.

    I authorize the use of such anesthetic or sedative agents deemed advisable in the performance of such surgical, diagnostic, or therapeutic procedure(s). I realize that the administration of any anesthetic or sedative agent carries a small but realistic possibility of side-effects that may include death. I realize that complications can occur due to pre-existing conditions or conditions not evident during physical examinations, blood tests, and other diagnostic tests. I agree to hold the staff of Alamo Feline Health Center blameless for all complications in the absence of gross malpractice.

  • I agree that if a change is needed in the performance of the procedure(s)stated above or an additional procedure(s) is needed and an unsuccessful attempt is made to reach me at the phone number(s) above, the staff of Alamo Feline Health Center has my permission to proceed accordingly, using their best judgment, and I will be responsive for any additional charges incurred.