Spay & Neuter Clinic for Cats *Male Cat Slots Only Left*

To the best of your knowledge, the above animal(s) has not bitten any person/animal in the last 10 days. If YES, please inform staff as required by law.

I, hereby authorize and direct the Veterinarian(s) of Pope Memorial Humane Society Cocheco Valley to perform the needed services and/or surgery on the pet(s) listed and that this contract pertains to any and all of my pets coming in for services if applicable.

I understand that there are both known and unknown medical risks associated therewith, including but not limited to infection, reaction, hemorrhage and death. My signature below releases Pope Memorial Humane Society Cocheco Valley from any liability associated with such procedure(s). I will not hold the Pope Memorial Humane Society Cocheco Valley liable for any medical or surgical complications or unforeseen circumstances including but not limited to anesthesia, surgery or vaccination. I understand that my pet(s) should be examined and evaluated as a surgical candidate by their regular veterinarian prior to surgery to decrease the risks associated with anesthesia and surgery. I understand that Pope Memorial Humane Society Cocheco Valley will perform a brief exam but will not perform a comprehensive cardiac exam, other diagnostic tests or blood work prior to the procedure. Pope Memorial Humane Society Cocheco Valley has the right to refuse treatment to any animal at the veterinarian’s discretion. If in the course of treatment a condition is discovered that requires medical attention or an additional procedure, a note will be made on the discharge paperwork so that I may obtain appropriate follow-up care by my regular veterinarian.

I agree to be available by phone during the day of the procedure(s). If a situation arises and I cannot be reached at the phone number provided, I authorize the veterinarian to use his/her discretion and clinical judgment as to what is in my pet’s best interest and to proceed accordingly.

I agree that I will be financially responsible for any post-operative/procedural medical treatment(s) relating to this procedure(s). I understand that PMHS recommends that my pet(s) receive continuing health care by a full-service veterinary clinic as needed.

If my pet is not picked up at the specified pick up time, Pope Memorial Humane Society Cocheco Valley will hold the pet for 24 hours. If the pet is not picked up by that time and I have not contacted PMHS to make arrangements for the animal to be discharged from the care of PMHS, then my animal shall become property of Pope Memorial Humane Society and made available for adoption, consistent with PMHS SOP’s following which I would be required to go through the adoption process and pay appropriate fees to reclaim my pet.