Authorization for Hospitalization/Treatment

I have discussed the reasons for hospitalization /treatment with Drs. Daugherty, McMurray, Wolfe and/or Preston, and I am satisfied with the plan of treatment. The nature of such services has been described to me to my satisfaction, and I realize that neither guarantee nor warranty can ethically or professionally be made regarding the results or cure.

If anesthesia or sedation is required, I understand there are inherent risks, including death. I authorize the staff to complete emergency procedures necessary for the well-being of my pet until communication with me is possible. 

Estimated fees were explained to me, and I understand there is a range of cost for anticipated services. I understand unforeseen complications are possible, and further treatment might be necessary during hospitalization. I accept full financial responsibility for any and all services rendered and agree to pay all fees incurred, in full, at the time of discharge from the hospital.