Repair of Prolapsed Third Eyelid Gland(s) Form

  • Assumption of Risks

    I am the owner or agent for the owner 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: anesthetic complications including death, infection, reprolapse of gland, loss of tear production, corneal ulceration.