Euthanasia Consent

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I, the undersigned, do hereby certify that I am the owner (duly authorized agent of the owner) of the animal described above, that I do hereby give the veterinarians, staff, and representatives of Central Veterinary Services complete authority to euthanize the said animal in whatever manner the veterinarians, staff, and representatives shall deem fit, and do hereby forever release Central Veterinary Services from any and all liability.

I do also certify that the said animal has not bitten any person or animal during the last ten (10) days and, to the best of my knowledge, has not been exposed to Rabies.

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Privacy of personal information is an important principle to Central Veterinary Services. In compliance with the federal Personal Information Protection and Electronic Documents Act (PIPEDA), we are committed to collecting, using, and disclosing personal information responsibly and only to the extent necessary for the goods and services we provide. The primary purpose for collecting personal information is to provide veterinary services.