Dentistry Form

Dental Cleaning Amendment

    While I, the undersigned owner or agent of the pet identified above, have authorized South Meadow Animal Clinic to perform the above procedure, I understand that there are certain conditions that can only be fully identified/diagnosed upon a thorough dental exam while the pet is anesthetized. These conditions can include but are not limited to extraction (removal) of diseased teeth and surgical removal of oral/gingival growths or tumors.

    The hospital staff will attempt to promptly contact the client upon any unsuspected findings to get approval for additional procedures and costs.

    I have read and fully understand the terms and conditions set forth above.