Medical Care Consent Form Client Name* First Last Patient Name*SpeciesBreedSexColorWeightAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Phone I hereby certify that I am the owner of the above-named animal or am responsible for it and have the authority to execute this consent. I hereby authorize the veterinarian to examine, prescribe for, and/or treat the above described pet. I agree to indemnify and hold Blue Oasis Pet Hospital harmless from and against any and all liability arising out of the performance of any of the procedures needed. I understand that the Blue Oasis Pet Hospital is not a 24 hour clinic and there is no staff at the clinic at night. For this reason, if my pet must be hospitalized and/or require treatments/surgery/observation, I understand that I will be required to transport my pet to a 24 hour/ER after hour clinic for continued care. If I refuse to tranfer, I understand I may be required to sign an AMA (Against Medical Advice) form. If an unforseen event occurs, I will not hold the Blue Oasis Pet Hospital, its doctors or staff liable for any events, including medical complications or death. I assume full responsibility for all charges incurred for the care of this animal. I also understand that these charges will be paid at the time of release and that a deposit may be required for surgical treatment. I grant permission to photograph me and/or my pet and to use such photographs for publicity, illustration, advertising and Web content. I give also permission to release medical and/or vaccination records. Signature of legal owner or responsible person*Date*CAPTCHACommentsThis field is for validation purposes and should be left unchanged.