Consent Form

Owner or agent's name:  ___________________________________________________

Organization: ____________________________________________________________

Address: ________________________________________________________________

________________________________________________________________________


I am the owner or the agent for the owner of the animals listed 
on the attached page, and I have the authority to execute this 
consent. I hereby consent and authorize Dr. Griffin and veterinarians 
and veterinary students under her supervision to perform medical and 
surgical procedures for spay/neuter on these animals. The nature of
these procedures has been explained to me and I understand what is to 
be done.

I also have been informed that there are certain risks and complications 
associated with these procedures and these have been explained to me. 
Furthermore, I understand that if unforeseen complications or disease 
arise or become evident, this animal may be euthanized at the 
discretion of Dr. Griffin, rather than recovered, to prevent undue 
suffering and distress.

I authorize the use of appropriate anesthesia and pain relief 
medications as needed before and after surgery. I have been informed 
that there are risks associated with the use of any medication.


Signed: ____________________________________________

Date: ________________________