I, the undersigned, do hereby certify that I am the owner (duly authorized agent for the owner) of the animal described above. I do hereby give Dr. Evelyn Tom, Singing Hills Animal Hospital, their agents, servants and/or representatives full and complete authority to perform the anesthesia/surgery or diagnostic procedure named above. I authorize procedures, at their discretion, that are advised and useful to promote/protect the health of the above described pet. I do hereby forever release Dr. Evelyn Tom, relief veterinarians, Singing Hills Animal Hospital, Inc., their agents, servants and/or representatives from any and all liability arising from said surgery or procedure on said animal.
