Owner:
Has your pet’s appetite and drinking been normal?
Has your pet been showing signs of:
Pain level:
I understand the doctor will contact me after examining my pet. In the event that the doctor is unable to reach me (Please check boxes):
Enter $ value here

Overnight care at SFPC is unsupervised at times outside of normal business hours. For safety reasons, no continuous IV fluids are given during hours where pets are not under direct supervision. This includes Sundays and Holidays.

I certify that I own the above animal, or am responsible for it, and I hereby consent and authorize the Sherwood Family Pet Clinic veterinarians and staff to medicate,

treat and/or hospitalize my animal. I acknowledge that no assurance or guarantee has been made except reasonable precautions against injury or escape and that risks

and probabilities of complications exist in any surgery, anesthesia or medical treatment. I certify that I am the responsible party for the above animal and assume allfinancial responsibility.

PAYMENT IS DUE IN FULL AT TIME OF PATIENT DISCHARGE.

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