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Pharmacy

Appointment

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SpecialistForm

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Specialist Form

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Client Name
I verify that I am the owner (or authorized agent for the owner) of the above-named animal and authorize Cecily Bonadio, DVM, DACVIM, of Pacific Paws Mobile Vet Care (PPMVC), to perform the requested procedure(s). I have been advised as to the nature and potential complications of the requested procedure(s). I also understand that sedaGon and/or general anesthesia may be required in order to facilitate the procedure(s) requested. I understand that the clinic listed will be in charge of, and responsible for, monitoring my pet while he/she is sedated and/or anesthetized. I understand that there is no guarantee or warranty made as to the outcome or results of the requested procedure(s). I authorize images of my pet to be obtained and used at the discretion of PPMVC for marketing or social media.(Required)
Clear Signature
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