Spay/Neuter Consent Form

The address should be the location where the pet lives. You do NOT need to live in Barrow County to use our clinic.




We recommend a microchip ($15) for all pets. You get free lifetime registration.












































I understand that there are risks associated with anesthesia and surgery and that complications including death may arise during or after the procedure. By signing, I agree that I am the owner or authorized agent of the animal described above and that I have the authority to offer consent for surgery. I hereby release Leftover Pets Inc. and its agents, including Dr. Amber Polvere, from liability associated with surgery or boarding at the spay/neuter service. I understand that I will not be contacted if my animal is discovered to be pregnant and that the spay procedure will be completed. For male animals with retained testicle(s), castration will be performed and the cryptorchid fee will be charged with no guarantee that the retained testicle(s) can be located and removed. I understand that the service does not require complete medical records on animals presented for surgery and that all animals presented for surgery may not be healthy. Cats may be given an injectable pain medicine which is used off label. This medicine is made at a licensed compounding pharmacy. You must tell us before surgery if you do not want your pet to receive this medication. I understand that my animal may come in contact with an infectious agent as a result of entering the clinic and that unvaccinated animals are at a greater risk for developing disease. Animals older than 5 years and those with health conditions such as respiratory or skin infections, obesity, pregnancy, or heartworm disease are at a greater risk for developing complications during and after the procedure