3310 Grant Avenue, Philadelphia, PA 

3310 Grant Avenue, Philadelphia, PA 

!
!
!
!
!
!
!
!
!

Changes:

!
!
!
!
!
!

ADDITIONAL SERVICES

1) Nail trims
2) Anal Glands
3) Vaccines
!
4) Ear Cleaning

Permission for Anesthesia

I hereby authorize Caring Hands Veterinary Clinic to use general anesthesia on my pet, ___________, For the above treatment/ listed on this form.

I understand that anesthesia poses a risk to my pet, even death regardless of health status. In the event of unforeseen complications, I give permission to the doctors and staff to take reasonable measures in treating _________ and accept all charges that are incurred as a result of such action. The anesthesia and relevant risks have been fully explained to me to my satisfaction.

!
!
!
!

Visit our Office