I, the undersigned and, owner and responsible of the pet described previously, certify that I have 18 years old or more and I give the authorization to the medical team of hacienda Urbana to perform on my pet the procedure(s) listed previously. I understand that it might occur risks related to the anesthetics, to the surgery, and that I have discussed with the doctor all my doubts related to the risks previously in this procedure. Mi signature on this form indicates that any question that I had related to the next topics were answered to my entire satisfaction:

• Medical options and surgical to this procedure for my pet.
• Enough details of the procedure until I have understood what procedure my pet is going to have.
• Recovery expectations related to time and how my pet is going to recover.
• The most common and seriously complications.
• The kind of follow up and period of time this recovery will take after the procedure.

When I accept that all the procedures will be performed on the best of the abilities of our team, I understood that there is no guaranty of the results that later could be.

Important:

The pet has to be with no food intake for at least 8 hours.

We recommend for this pet:
o CBC
o Pre anesthetic blood panel
o Thorax x-ray, abdominal x-ray
o Test 4dx
o Physical evaluation
o Need to present your shots record, they must be updated.

In case the shots are not updated, we will update them, and they will be charged in your bill. If the shots record is not from a legal center with a veterinary doctor, member of the main identity of the country that regulates the veterinary professionals (colvet) shots has to be applied again.

The shots record has to have the labels of at least the last shots applied, and the date on those labels has to be on date with the application date of the shots. In case the owner brings the card, and it doesn’t have the labels of the shots, a formal certification made from the doctor of the center they were applied has to be presented.

The dates on the labels must be current within the range of application of the vaccine.

o The pet must not have any external and internal parasites. (fleas, ticks, mites)
o The dewormers have to be up to date.
o Is mandatory that the pet having the procedure has a bath before the procedure.

To go:

• Owner must take home “the cone of shame” for at least 10 days after the procedure if the doctor suggests it that way.
• Must take anti-inflammatory and pain meds for the next 10 days and antibiotics for the next 7 days after the procedure.
• Must take an ointment for the healing of the wound.
• Must take special food for the next 24 hours after the procedure.
• Must come for a follow up 15 days after the procedure.

If the pet doesn’t come for its follow up, and doesn’t do all that we recommend previously, the clinic and the doctors are not responsible for the effects and results of the procedure.

All these regulations are made for the safety of your pet and the wellbeing of the client and the hospital.

I have received an approximate cost of all the procedures that are going to be done today.

The amount has to be paid 70% before the procedure and when the pet leaves the clinic the total.

The bank transfer from a different bank that is not the popular, has to be done “paid immediately” otherwise the pet will stay on the clinic until the payment is completed, the boarding has to be paid by the owner of the pet.

If the client is not agreeing, we will only perform the ones the client chooses from the services listed previously and the hospital and any of their personal is free of any action, present, or future that the client might want to take because of any unexpected situation that might occur. The client signed this document free and voluntarily and assumes any consequence that might be present, this consent represents a discharge of the hospital/clinic and all the ones involved.