Wai

verofLi
abi
l
it
y

Thi
sistocer
ti
fythatIam f
orgoi
ngther
ec omendedbl
oodtes
tingofmypet
/spr
iort
o
sur
gery
.Ibel
ievethatmypet/si
s/ar
efi
tforsur
gery
,andIam awareoft
heri
sks.

PAWSandi tsshel
tervet
eri
nari
anwillnotbeheldl
i
abl
eintheeventofcomplic
ations,
i
njur
y,ordeatht
hatmayr esul
tfr
om t
hes urger
yduetoundi
agnosedil
lnessesthatcoul
d
havebeentreat
edifabloodtestwasperfor
med.

: __________________________________________
Nameofowner
Nameofpet
: __________________________________________
Speci
es: __________________________________________
Br
eed: __________________________________________

________________________ ________________________
Si
gnatur
e Date