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Greys and Strays, LLC Alysia Deaven, VMD 717-304-9987

Spay/Neuter/Vaccination Clinic Liability Release Form: FERAL/OUTSIDE ONLY FELINE

I, the undersigned owner or owner’s agent of the pet identified below, hereby consent and authorize Greys and Strays and its staff to receive, transport, and have spayed or neutered the following animal(s). I will not hold liable or responsible Greys and Strays and staff for any and all claims, liabilities, losses, damages, charges, fees and expenses of any nature and character which I or my animal(s) may sustain or incur by handling, attending, treating, vaccinating, spaying and neutering. Greys and Strays is to use all reasonable precautions against injury, escape or death of my pet. I understand that all anesthesia and surgery involves some risk to my pet (like unknown internal abnormalities, medication/sedative allergies, surgical complications, internal bleeding, shock, incision dehiscence, post surgical infection and death) and that I am encouraged to discuss concerns I have before the procedure(s) is/are initiated and agree to hold Greys and Strays harmless, in the absence of negligence, in connection with these procedures. While I accept that all procedures will be performed to the best of the abilities of the staff at Greys and Strays, LLC, I understand that vet medicine is not an exact science and no guarantees have been made regarding the outcome of this/these procedures and no guarantee of successful treatment has been made. In the event that complications arise and I cannot be immediately contacted at the number listed below, Greys and Strays is directed to make the decision deemed best for my pet. There is an increased risk of infectious disease development in unvaccinated cats and some feral cat colonies that are carrying infections that are expressed during stress, like surgery and vaccinations. I understand that I assume all responsibility for all risks. All cats should continue to receive healthcare from a veterinarian throughout life. Greys and Strays reserves the right to hold or keep any animal for health, safety or treatment reasons in order to protect that animal. I agree to pay for services rendered. I have read and understand the nature of the above procedures and accept the specific terms and conditions set forth herein.

Print Name__________________________________Phone ( )______________________

Address ____________________________________ City________________Zip__________

Stray/Feral Name__________________________Circle: M or F; MC or FS WT:________

Breed__________ Age/Birthday_______ Color__________ EMAIL:_________________________

PLEASE CIRCLE DESIRED SERVICES

SPAY (female) $45 ( $10-20 charge for pregnancy, complications) NEUTER (male) $35

Post-op pain med: Meloxicam injection with SQ fluids $10.00—RECOMMENDED!!!!!

VACCINATIONS

RABIES $10 –must be 12-16 wks; boost in 12-14 mos then every 3 yrs

DISTEMPER/FVRCP $10 (Panleukopenia, Rhinotracheitis, Calici) Kittens: vaccinate every 4 wks from 8wks til 16 wks of age, then 1 yr then every 3 yrs; Cats over 16wks: need 2 vaccs spaced 2-4 wks, boost in 1 yr, then every 3 yrs

FELINE LEUKEMIA: $30.00 need 2 spaced 2-4 wks apart; MUST HAVE NEGATIVE LEUKEMIA TEST!!!

*** Kittens/small cats get ONLY 1 vacc/visit; No more than 2 vaccs/visit *** WE SUGGEST VACCINATING BEFORE SURGERY TO MINIMIZE STRESS AND ILLNESS***

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FLEA MEDS: REPEAT ONCE A MONTH

Fleas /Ticks/Lice (FRONTLINE PLUS): $10 Fleas/Worms/Ear mites/Mange (REVOLUTION):$10 **************************************************************************************

DEWORMERS

1: PYRANTEL PAMOATE (Hooks/Rounds): $3 DEWORM EVERY 2-4 WEEKS FOR AT LEAST 4 TIMES, THEN ONCE A MONTH OR EVERY 3-6 MONTHS DEPENDING ON LIFESTYLE

2: PROFENDER: TOPICAL FOR HOOKS, ROUNDS, TAPES***ONLY RETREAT IN 30 DAYS IF REINFECTED***

$15 (2.5-5#); $15 (5.55-11#); $15 (11.1-17.6#) MUST BE 8 WKS AND 2.2#

FECAL CENTRIFUGE EXAM: $20.00 GIARDIA TEST: $25.00

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MICROCHIP: $40 Ear Tip FeLV/FIV/HW TEST: $40

PRE-OP BLOODWORK SCREEN TO CHECK KIDNEY AND LIVER FUNCTION

We can run tests to confirm that your pet’s organs are functioning properly to eliminate anesthesia risks. We may also detect hidden health conditions that we could treat early and provide baseline levels for the future. If preanesthetic results are within normal limits, anesthetic risk is minimized. If results are not normal, we may opt to not do the surgery. We cannot perform this before sedation in FERALS. THE COST FOR THIS IS $40.00

PLEASE CIRCLE: I DO OR I DO NOT AUTHORIZE PRE-OP BLOOD SCREENING

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SIGNATURE DATE

I HAVE READ AND UNDERSTAND DISCHARGE INSTRUCTIONS:________________

INITIALS

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