Eyelid Reconstructive Surgery

  • Assumption of Risks

    I am the owner or agent of the above animal and have the authority to execute this consent. I hereby consent and authorize the performance of the following procedure:
  • Risks of the above procedure(s) include (but are not limited to) the following: 1. Anesthetic complications including death 2. Infection 3. Corneal ulceration 4. Trichiasis (hairs rubbing on cornea) 5. Additional surgery may be necessary