Rescue Partner Waiver Order Number Organization Name Names of authorized agents and contact numbers * If a pet you bring to our clinic for sterilization is found to be pregnant, how would you like us to proceed? * Continue with spay Do not spay Please contact us to discuss the animal's stage of pregnancy, allowing us to make an informed decision. In the event of a pet's cardiac arrest, there is a critical window for effective CPR. Please advise on your preferred protocol for such situations * CPR under anesthesia DNR (Do Not Resuscitate) Authorization for Sterilization Surgeries and Treatments I, the owner/agent, have read and understand this agreement and authorize Rescue One to anesthetize, surgically sterilize, and provide other related medical services or treatments. I understand there are medical risks, including but not limited to infection, hemorrhage, allergic reaction, anesthetic drug reaction, anesthesia-induced cardiac compromise, and death. I understand that Rescue One will perform a physical exam but no other diagnostic tests or blood-work will be performed prior to the procedure unless instructed to by an agent for your organization. I understand that the animal will receive a small tattoo on his/her underside to show that he/she has been sterilized. I agree that I will be financially responsible for any post-operative medical treatment relating to any procedure or treatments or any other unrelated medical problems of my animals. By signing this Waiver and Release Agreement, I am consenting to the medical procedures being performed on the animals we bring to the Rescue One clinic and all related activities of any kind and acknowledge that I understand that all risk, whether known or unknown, is expressly assumed by me and all claims, whether known or unknown, are expressly waived in advance. I hereby release, discharge, indemnify and hold harmless, Rescue One and its directors, officers, employees, volunteers and agents from any claims, causes of action and demands of any nature, whether known or unknown, arising out of or in connection with the medical procedure performed on the animals and all related activities. . * Electronic signature of authorized agent *