I certify that I am the legal owner/duly authorized agent for the owner of the animal described above, and do hereby give Smithfield Animal Hospital and any authorized agents, staff, or representatives full and complete authority to euthanize and dispose of said animal in a humane manner.
I hereby forever release and hold harmless Smithfield Animal Hospital and any authorized agents, staff, or representatives from any and all liability for euthanasia and disposal of said animal. To the best of my knowledge, my pet has not bitten, scratched, or otherwise potentially exposed any person or other animal to rabies in the past ten (10) days.
I understand that if the animal described above has bitten or otherwise potentially exposed any person within the time specified, a rabies test must be performed. I understand that euthanasia is the act of ending the life of an animal in a painless way to prevent any unnecessary suffering. To the best of my knowledge, the information I have provided is accurate and complete. I understand that my wishes may be carried out immediately upon my signing this agreement. Fees for these services have been explained to me, and I assume full responsibility for all charges applicable to such services. I have carefully read and fully understand the foregoing provisions.
