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I, the undersigned owner or owner’s agents, of the above pet(s) understand that my pet(s) cannot have any food or water after midnight the night before the surgery.

I, the undersigned owner or owner’s agents, of the above pet(s) certify that I am in lawful possession of the abovenamed pet(s) and that I am eighteen years of age or older. I hereby consent to have surgery performed on my pet(s). I understand that this is NOT a veterinary hospital, but a low-cost surgery and wellness clinic, and I hereby understand that no pre-surgery testing will be performed on my pet(s). Subsequently, I understand that risks, including but not limited to infection and death, exist with the use of anesthesia and/or surgery. I understand and authorize that any surgery that will be performed on my pet(s) will be completed by a licensed Veterinarian in cooperation with the Columbia-Greene Humane Society/SPCA. Further, I understand that I am financially responsible for all costs incurred during this surgery, treatment, and hospitalization.