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I am the owner, or owner’s agent, of the above named pet. I am over 18 years of age, and I have the authority to give this authorization and do so voluntarily, having been advised of all of the probable and material risks associated with the treatment. I understand that unforeseen conditions may be revealed during the identified procedures which, in the opinion of the attending veterinarian, may require more extensive or different procedures or treatments. I authorize the performance of any procedures or treatments which are necessary in the professional opinion of the attending veterinarian if reasonable efforts to contact me in advance are unsuccessful.

The veterinarian has described the procedures identified above and has explained to my satisfaction the purpose for performing them and the risks involved with them. I realize that there is a risk of death with every anesthetic, and that there can be no guarantee regarding the outcome of any procedure. I authorize the performance of the identified procedures and the use of associated anesthetics and other medications.

I am the owner, or owner’s agent, of the above named pet. I am over 18 years of age, and I have the authority to give this authorization and do so voluntarily, having been advised of all of the probable and material risks associated with the treatment. I understand that my pet, being an exotic animal, has an additional increased risk associated with sedation and/or anesthesia. I further understand that unforeseen conditions may be revealed during the identified procedures which, in the opinion of the attending veterinarian, may require more extensive or different procedures or treatments. I authorize the performance of any procedures or treatments which are necessary in the professional opinion of the attending veterinarian if reasonable efforts to contact me in advance are unsuccessful.

The veterinarian has described the procedures identified above and has explained to my satisfaction the purpose for performing them and the risks involved with them. I realize that there is a risk of death with every anesthetic, and that there can be no guarantee regarding the outcome of any procedure. I authorize the performance of the identified procedures and the use of associated anesthetics and other medications.

Indicate whether bird does any of the following behaviors: (Press Control & click to select more than one option)

What, if anything, have you done to try to treat the problem (medical treatment, behavioral therapy, medications, supplements, herbs, etc.) and indicate if the attempted treatment made the problem better, worse or did the behavior not change due to treatment?