Removal of Third Eyelid

  • 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. loss of tear production 4. corneal ulceration
  • Please Sign or Initial
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