What Medication is your pet currently on?

In the event of dental cleanings, from time to time it may become necessary for the veterinarian(s) to extract unhealthy teeth. It is not advisable for the doctor(s) to leave your anesthetized pet to make phone calls for your permission, we recommend you give us permission in advance. In the event you decide not to give us permission, we will be forced to leave the unhealthy teeth in your pet’s mouth.

I have been advised as to the nature of the procedures or operation and the risk involved. I realize that results cannot be guaranteed.

I realize that my pet will be discharged only during regular office hours and the fees due for its care will be PAID IN FULL at that time. **Estimate can be given prior to your pet’s procedure upon request. **

In the event that I change my plans, become ill, change my address, or otherwise lose contact with the

hospital, it shall be my full duty to inform Brenner Animal Hospital in writing immediately of such changes

**SPECIAL NOTICE**

ALL PETS WITH FLEAS OR TICKS WILL BE REQUIRED TO HAVE A FLEA/TICK TREATMENT AT THE OWNERS EXPENSE

**PLEASE LIST A DAYTIME NUMBER WE CAN REACH IN CASE OF AN EMERGENCY**