ࡱ> `b_ UbjbjtWtW 48=g=gUxxxxxT<]P\\\\\\\`Bc\\x\xx\wwwxx\w\wwwɿ.qw\ ]0<]wc_ cwcxwTBw\\k <]cX >: Greys and Strays, LLC Alysia Deaven, VMD 717-304-9987 Feline Spay/Neuter/Vaccination Clinic Liability Release Form I authorize Greys and Strays and its staff to receive, transport, and have spayed, neutered or vaccinated the following animal. Greys and Strays is to use all reasonable precautions against injury, escape or death of my pet. I understand that all anesthesia and surgery always involves some risk to my pet (like unknown internal abnormalities, medication/sedative allergies, surgical complications, internal bleeding, shock, incision dehiscence, post surgical infection and death) and that I am encouraged to discuss concerns I have before the procedure(s) is/are initiated and agree to hold Greys and Strays harmless, in the absence of negligence, in connection with these procedures. While I accept that all procedures will be performed to the best of the abilities of the staff at Greys and Strays, LLC, I understand that vet medicine is not an exact science and no guarantees have been made regarding the outcome of this/these procedures and no guarantee or assurance has been made to me as to the results that may be obtained. In the event that complications arise and I cannot be immediately contacted at the number listed below, Greys and Strays is directed to make the decision deemed best for my pet. There is an increased risk of infectious disease development in unvaccinated cats and some feral cat colonies that are carrying infections that are expressed during stress, like surgery and vaccinations. I understand that I assume all responsibility for all risks and additional risks/complications resulting from refusal for screening procedures incl financial responsibility should complications arise during the requested procedures. Greys and Strays reserves the right to hold or keep any animal and refuse surgery or vaccinations for the pet's health or safety in order to protect that animal. I agree to pay for services rendered. I have read the foregoing, understand what it says, and agree. Print YOUR Name___________________________________________Phone ( )______________________ Address _________________________________________City___________________________Zip__________ Pet/Stray/Feral Name__________________________Circle: M or F; MC or FS WT:________ Breed__________ Age/Birthday__________Color___________________EMAIL:_________________________ PLEASE CIRCLE DESIRED SERVICES SPAY(female) $55 (Add'l charge: pregnancy, complications, lactation, hernias, heat etc) NEUTER $45 PAIN MEDS: REQUIRED 1: Meloxicam injection w/SQ fluids given here: $10 This is the med typically given unless under 4 mos of age 2: Simbadol-used under 4 mos or IN ADDITION to Meloxicam: up to 7#: $10;7.1-10#: $15;10.1-13#: $20;13.1-17#: $25 3:Therapeutic Laser- used ONLY IN ADDITION to Meloxicam/Simbadol:$10 ************************************************************************************************ BLOODWORK DECLINED:__________________ FeLV/FIV/HW Test:$50 Recommended for all kittens and cats before comingling; CBC/ Chemistry Panel/Lytes/SDMA $175 Tells us if organs are functioning properly, detect health conditions, provide baseline levels; Cats OVER 5 yrs of age MUST have an EXAM AND BLOOD WORK here BEFORE surgery ************************************************************************************************** VACCINATIONS: WE PREFER VACCINATING BEFORE SURGERY TO MINIMIZE STRESS AND ILLNESS PUREVAX RABIES 1 YR $15 Required at 12-16 wks of age; Vaccinate once a year PUREVAX RABIES 3 YR $60 Proof (certificate) of previous vaccination is required for this vaccine PUREVAX DISTEMPER/FVRCP $10 (Panleukopenia, Rhinotracheitis, Calici) CORE!! We follow the 2020 Feline Vaccination Guidelines and Dr Alice Wolf; age determines the # of vaccs and the timing of these; 1 yr+ only require 1 vacc; the final vacc is boosted in 1 yr then every 3 yrs WAIVED FOR SURGERY:_________ PUREVAX DISTEMPER/FVRCP $25 3 YEAR VACCINE-can only get this vaccine after the 1 yr booster PUREVAX FELINE LEUKEMIA: $30.00 Vaccinate twice, 2-6 wks apart; Negative FeLV test required; rec for kittens ********************************************************************************************************* DEWORMERS, FLEA/TICK PRODUCTS, DECLINED:________________ 1: PROFENDER $15 TOPICAL for Hooks, Rounds, Tapes; Must be 8 wks and 2.2# 2.2-5.5# 5.5-11# 11.1-17.6# 2: DRONTAL (Hooks/Rounds/Tapes) Oral pill; Must be 8 wks and 2#; should be repeated 3: PYRANTEL PAMOATE (Hooks/Rounds): $3 DEWORM EVERY 2-4 WEEKS FOR AT LEAST 4 TIMES 1:Cheristin:fleas$15 2:Frontline Gold: fleas,ticks,lice$15 3:Revolution plus:fleas,ticks,worms,ear mites 4:Seresto Fecal Centrifugation: $40 Giardia Test: $25 Microchip: $40 Claw Trim: $5-10 EAR TIP: N/C __________________________________________________________________ SIGNATURE DATE I HAVE READ AND UNDERSTAND DISCHARGE INSTRUCTIONS:________________INITIALS <=DZyz| ! < C0SXl,5[l*RǿǷǿǫǿǣǣǗLJhe hwhh5CJaJhhw5CJaJhpqCJaJhvhw5CJaJh'VCJaJhXhCJaJhvhwCJaJhCJaJhmBhw5>*CJaJhw5>*CJaJhhw5OJQJ3=z[r#*> e 0]^0gdv$0]^0a$gd)KZ$0]^0a$gd`q`$0]^0a$gd`q`0]^0`gdw 0]^0gdw $L]La$gdwgdkRr  !"#*3456=>AJTUɻwoh hhwh`q`hw5hihw5OJQJhihiS75>*OJQJhih[*5>*OJQJhih5>*OJQJhihw5>*OJQJ h`q`5hv hP5h?hw5hhw5 hk5 hw5 h'`xhw"h?!hw5>*CJOJQJaJhw(UW`kp "-.3e{vqlq hP5 hv5 hiS75 h^5>*h2hv5>* hv5>*hM=hi5>*hM=hi5>*OJQJhM=hM=5>*OJQJhM=hi hvhv hk5he h[*5hr5h[*h`q`hw5h)KZhwh/*h!b hhwh`q`*e@|"#45  0]^0`gdpq 0]^0gd" 0]^0gdw0^0gdP $0^0a$gdXh0^0gdw 0]^0gdv$0]^0a$gdi>?@DTZ_adeq{|ɾɞseYh'`xhw6CJaJhihw5>*OJQJhihw5>*OJQJhXh5OJQJhw5OJQJ hvhvhwhvCJaJhiS7CJaJhkCJaJhLQCJaJhk0hwCJaJhwCJaJ hw/5>* hx5>* hw5>* hiS75>* hxhiS7h[*hiS7hv  "#6;=T^z侶ڭڑ~sds~sYYYh7hCJaJh7hwCJOJQJaJh7hwCJaJh7hw5CJaJ hw5>*h'`xhwCJaJh06CJaJhw5CJaJh5CJaJhwCJaJhghwCJaJ h lhwh lhw5>*he hw5>*h'`xhw5CJaJh'`xhw56>*CJaJ"#<DR_mpqv345;xxpbh'`xhw5>*CJaJhPhP5h06h06\ h065 hP5 hP5>*"hPhP5>*CJOJQJaJhM=hM=5>*CJaJhPCJaJhCJaJhPhCJaJhPhM=CJaJhPhCJaJhPh'VCJaJh7hPCJaJh06CJaJ&;LNTY^fiu   +;<EMøӰxj\QQChihiS75>*OJQJhi5>*OJQJhih"5>*OJQJhih'V5>*OJQJhihw5>*OJQJhM=5>*OJQJh"hXhCJaJhwCJaJhghw5CJaJhLQCJaJhghwCJaJhxCJaJhvCJaJhwCJaJh'`xhw5CJaJh'`xhwCJaJh'`xhw5>*CJaJMNY^_`jko  0ACERpqrsʴʉ}qh_XS h"5 hLQ5>*hw5CJaJhiS75CJaJhmBhw5CJaJh/hw5hw hw5>*hkhk5hkhk\ hk5 h;jhkh;jhk5hkhhk5hhk5>* hk5>*hpqhw5>*OJQJhi5>*OJQJhpq5>*OJQJhiS75>*OJQJ _qr\]STUgdw 0]^0gdP]gdk 0]^0gdk 0]^0gdw0]^0`gdpqs}~&+46=>DORV[\]RSɿzu hM=5 hvhvh hvhw hw5 hw5>* h065>*hThw5>* h5 h %@5hThw5hwh2hw5>* h"5>* hPh"h"hkh 5>*h"h"5h h"5hkh"5>*.STUhXhw21h:pv/ =!`"`# $ % x 666666666vvvvvvvvv666666>6666666666666666666666666666666666666666666666666hH6666666666666666666666666666666666666666666666666666666666666666662 0@P`p2( 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p 0@P`p8XV~ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@ 0@66666 OJ PJ QJ _HmH nH sH tH L`L wNormal$CJOJPJQJ_HaJmH sH tH DA D Default Paragraph FontRiR 0 Table Normal4 l4a (k ( 0No List HH w0 Balloon TextCJOJ QJ ^J aJR/R w0Balloon Text CharCJOJ PJQJ ^J aJPK![Content_Types].xmlN0EH-J@%ǎǢ|ș$زULTB l,3;rØJB+$G]7O٭Vj\{cp/IDg6wZ0s=Dĵw %;r,qlEآyDQ"Q,=c8B,!gxMD&铁M./SAe^QשF½|SˌDإbj|E7C<bʼNpr8fnߧFrI.{1fVԅ$21(t}kJV1/ ÚQL×07#]fVIhcMZ6/Hߏ bW`Gv Ts'BCt!LQ#JxݴyJ] C:= ċ(tRQ;^e1/-/A_Y)^6(p[_&N}njzb\->;nVb*.7p]M|MMM# ud9c47=iV7̪~㦓ødfÕ 5j z'^9J{rJЃ3Ax| FU9…i3Q/B)LʾRPx)04N O'> agYeHj*kblC=hPW!alfpX OAXl:XVZbr Zy4Sw3?WӊhPxzSq]y U8RU;MsSUe U8@0(  B S  ? 38TVgkw{)+W;> R Y -  49".BKr}-;W3333333333333333333 k k - . TT^^zmv3_qq4=TW k k - . TT^^zmv3_qq4=TW%" a""?FwZ[~ff{i-jmx+ {t/1JA[FLPSU[Y`o|}.b!!4&ES.o @g%'+qP(Tccix1} *'/+:2MN]QS%T>mosiz0 G Bh3GDDEEIN_`cdt=z:(-.0)HOH]_bmowp:w{t%@*-/77m:?%E#RYZk!}~UI-(0V2%6+V/_achs|Z 2  C) 3 7 O >Q R ^ a 'e r t w ax  [ t  # & 6 @ G L V \ _ h n v x { | & a9 [: < = > BC AD =H N Y g q v iv   z# ( ( 23 C F >F pF ~H gL qW [ c e g wq J " q  & 5 K ,R b o :u Bu } V xf*CtPSpX[~gq|*: <Q%[bdpuh{+So!j/55:?BMM`nw}>G#c&);&F T=UZ^ e|P`  N <"45tAK6MMnV3WvWZ^iu} D%x&14DFfHK_Q7SUV'XZ\acv&$C%l*B,I<MZQqR!aafm^v v "000$DMN6_djj/{~"*8\@QU\^0e7j| '!/7W>BA'GQL^zg2h:; Y !:''!( /HLUhV^cffq|OR_$/'0/4PAIMNTM[]^aYnoq P})/7<rGGX[tv~u_1b369:@A$JNcXY\`gkLnz{~6F P&)* 2U;IOOQTYx%z~ _((.|.0 1;G<<>a@@0ALR\_)qRqrtw A$$$.~0?;FjJ[c_gIg69b<DgIkKoMgNCQZacUftwxyz|  ^   e. / 0 g> *C*BE*bI*QM*M*bk* +U+i++m+F$+(+j/+K7+n9+;+ D+HD+^K+e+wk+w+z+u,,,&1,k5,<,vC,DR,4V,[,p_,h,n,--!,-0- 6-TG-G-Q->S-]\-a_-d-x-s~-..,.-.t:.GB.F.\g.i.j./!/ /*/,/&./a./:/@/K/V/Z/A]/^/i/o/w/x/0000(0!040.<0pA0B0G0(Y09e0e0l0n0x01I1[ 1 111&1)131H1eO1Q1`1d1ym1"w1 >>(>s->\/>7>G>J>WK>nV>Ro>}>A>/? ? ? ?/?X5?:?s:?=???7D?H?I?J?bY?a]?~q?{?@ @@T@@f!@$@ %@2@l4@@@J@]@m@Qp@vp@r@ AA#A~1AEAEATAeAAiAiAiAjAoAj~AB B BtB&B.B3B>BCBuRB UBRYB[BiBoB/qB0Cq CACC=C"Cj,C /C}/C2C3Cu8CPCG?GNFGVNGWPGPG^GcGfGgGRlG/HH HFHH H/HP0Hw2Hc4HGHKH_HcHrHsHH<I% I IIII #I&I 3I5IP:In=IKISIlIlImInIzqIiJMJfJ$2JKJ.NJNJTJbJeJWxJK K~!KZ$KF)K6K9K`GKPK-SKTKJWK3[K&hKWsK\L0L4LQ7L~JLPUL[LO]LBiL"wL{L|LMM&Mi,M9M?MhTMXMZMyMdNNWN] N,N0N5N9NS;N&UNwNyNOOO O"O#OQ&O3+O--OsEOIOIOKOUlOXoOxOPPPFP#P|$P5&P'P(P9,P-Pr:PV _V1`VJlVxV4 WdW(W2W@WZWaWdWXXX!X'XJ>XINX{VX ^XaXbX:eXfXYeYY!Y($Y%Y+YBYDYHYP[Y`YgrYtYuYyY?Z) Z Z ZJZj'Z /Z]q@]E]E]eP],W]e]~]+^9^A^^k ^'^+^ <^D^I^J^R^=T^Y^[^b^_d^g^q^x^_g_n"_._0_:6_~7_!S_V_a_~_I_```` `(`$+`-`H`b`j``q`,|`aaaa*a.-a/a3a=a_afakaqab9bQby b bzbv$bB0b4b:b!d"d'd+d:d;d(EdMEdQdgVdZd^dVhd1jdmpdudxd{dee eejee e%e'ej-e`9e:e@eZHe-KeKeReoWef^fef ff:f!f%f'f2f>f.?f\f4xf{fg%g"g{&gq-g1gl2g @gyBgDgMgQgVZg]g hY h)h-h-h.hi3h;hChVhYhfhoh iA i@ i i7iii#i2+i5iw5i =iAitBiSi\i\fifiwi{i{ijj} j jjjj jN!j*j+j+j2j36j6j49j=j!EjLjSjYj%ljzwjzjk kkkkk#kk'k,k.k&2k4k_7k{Mk[ks_k4`kAhk}vkvk}kl$l&lL4lTMlMlTl_l@jlllrlxlm!m@"m#mBmUmoWmfmKlmomjrm@tmtmn/n?JnNn\n^ni_nbn=inin~qnUrnrnoroooJo?o$oW&o1o8oBDoDoMo_o_ozbokolo0monorompp p! ppV,p@2pBp_KpKpX[p[p9mpsptptpvpvp@|pNqS qqqD0q3q6qp9q-DqFqdqmqqqtq~q%r rArOr>\r]r*kroror&qrrrsrwrrsssps`$sr%s31s@wo@wXw8Zwu\w4]w]w]^wm`w ow}w xPx,xF-x81x2NxVx\xcxLlx7xxaxxy1yKyt1y=yEyGytIyJy TyWy3_yayYdy4eysy(tyHuy yyzy|yzB zzpzH"zw'zIzSzUzZzbz+hzjzyqzjwzRyzz^{b{{{){8{XU{YU{Y{a\{Ad{wm{q{r{y{% ||L!|'|J|L|N|AU|TU|?X|\|8`|i|j|k|Wq|n}}}}}"})$}+}@2}uH}S}V}#W}b}m}o}|}H~/~X.~/~1~2~6~A~Y~cd~m~an~r~r~t~|~$76j#w11O=>yEGRRacz ?. $%&z38\:HmILLkPnt!! "%044p7CUW)efiq6Q!='1Cn_ii,kltI%[*B--.3O77w;@C7G`KTi`nt~~h  "VBDeKoP;XhosvZ{b 0u#W*f+-D2278699E<?|@BGG6IQddchiuL}h V$1{22o3+>&B|B?E1F>MQY_KpMsv{y |%3-<!?IQ7UwY[qcjK"#6:>NGWG[{^_k{, f  r,-I26^9_JS5XRYZ`!b;crvw"')/|29RIJKQY_e  'f,7yEnFMNOPW/\|B MlPR/TZObexn{@~ !$8(6;GO*ZZ-dSnYnv{Jo '#x#3'ABMCLU[?fEppv`wP#d-)91;+?? @mCCIW\Y*[a__fjqBu{U$|&],0039<7>F\PTZObeirx~X|&&R0o9m<BCxFSPT!Zgakpm t'6.>DHmcem\noqjtG ..<MAFKMS.( a>*1%4^4B?F\P W [^mc;npv%|   39B8PW rv|5:# )34sKT^WcXhirl'59:zHU4UcUWZ[]bNodqwN> =g} #-/3?vG=IfY1bblqdvfv| E!P"C#&B@@TZ^hotxm|+z @H& *024 6MThjmp}} g,k1z15i7`(cpwg=6 _!CDHSTY[$lVpf >#(->EJRX_ himBqvOl @%,4r579z:gE'Ng]afqlq|3~ ) NCO$x0G3@ABmK~LMM`0bemrw{q#=*y779>?@MF3QRQ`nv~ (++Y<<ksNz(/tG=IKO$g|@!)u.337<DEJO:Pegkovsz]{&135AJORdWd g4 -8qHY?^ij&A(-7?E/?`DJxKLMoNO UVtbwxn Q/27>;;f<>PJP/jklf q  T!W%.45EFJ9STVi\^elisAz & F""*/01?F'U&V`rbNksx{yUcK3&u().18dAxdxxm$ $!!H7dfjsnvD| }a'$*>>ExGtVacno{ (U"c>@DPLQX_a!dqu  6f$q>DEKOZ^mo|  !%,0 6?OZft !]""2(B0DR.j wZ|} $~S*1+,E11J:DNUWUXbfx  +e.8//= At~dN7J!+:?B.afk$lhx #136$89?B_CHHOU6^`BbcYcp)qxS+HKY\`tv| *C:&7))FTdQhm'nsvx|g^  '*3OMUef$u"-X>>d?RH`QZ8ablw%}a! -:;?API'KZ[egjPlyv j!])8XFMpXG\c  0(!"48}>@AD[_aks}j!]$(&+)GK]``eqt?x~z 4:=JEXhstqxN !iK{L_pWpp(skz{ "W%%&{(079_cgp*u!+$0<UB=NJXY]b*m{ 2$5IUWXfYh > tr=r3_F#RSgYY[fziGjpirI%&{..oDDJRV:llgs? $x',8=b@FdHHcT\`fopqsu ")-t5< ?RDVhvs *C(*@D1VMVW^^fhiBj1t j #q+/`CC!HKPSW\"mru -5HQYx\?ad7p\s!+,=< JJpFv Db p/3;7m8~>?D8ENEUFHfXkhlCpAvw4"&L**ALS5`moqwt~~; ^SW$/556BdCNqU\2fdf1nnSooqa%-/31wIUJM@RSosw{|}$+0.9IOSFfpx z$,.7K_aXruv!*+AS\btl 22"#3(:>D:NNO 9"8i9r@FCPZ%Zgm~opu Pjk %%38AA]CJNW_b^mnYrtuz*())<m>CJMFQQY\kber(}& ))115&E>LwU|V^a3ouAw'19BG:O1bg krz+16c8<AnAGUJY\f~lf} jJc.;7=>yA*BMCFsTXfHhu{5 _*g+V89sDINKTY^Im?w~" Sb%?@CbN]*dMefw|D}KpL .!,/|ACDGO[abedfGll } ~/2~:?vi3yd!4/48B9hAE6N~NOTW_@bgOhqOvzr(M,B2?kG|Zhcf9g-hCp|9< s%&&-O2B{HuPlI}SAErFTLS[dGejqn8ux /7 <BsFG"I5]ddos=}L69<+:.99FHP|S[`9fgEksu`{LSMZl'^<>A(K[\njppzDQz i,Q67EGWW_"`bAelv~x A07VW&ZO]dfhkRouuuzu%C(767INRegnqy~g%_(M5:AaADENQaGcdjjwow0=P0349>uIPe_FmpD^#K&*4329=<?CyFFJXY^dppq' 25AO$STYRYZu~[ #'1347DEI"JLMbfl~ J,}25`D{N\S`s t#}%B*082:DFGNOgSky X"F'8XA*TUXZ]lv&c,}9!BDJJ.R^R3Vr^"iipiz~/Z11 ;<EMEIX_b(gFl~ Z#"&7;CGWXY^`acknv  "02;<kGGOOQVbcf1n&r2y  ?\ R'>(-015?EAmFGORx\`cye$&[0q7A?G^]g#ikkr{|6e +y.e4=AGICVozlv ,f)9;<V?YKUsuw}b ^%&(8I\`b}fkmnorywUW@U@Unknown G.[x Times New Roman5Symbol3. .[x Arial=Lucida FaxABook Antiqua7GeorgiaW.Copperplate Gothic BoldO,Perpetua Titling MTE. Century Gothic7..{$ Calibri5. .[`)TahomaC.,.{$ Calibri LightA$BCambria Math"qhKimZKi*5M $M $!` 20KK3QJP $Pw2! xxEe  Ladysodivine alysia deaven Oh+'0x  ( 4 @ LX`hpLadysodivineNormalalysia deaven42Microsoft Office Word@~*+@LgH@(|gH@.M ՜.+,0 hp|  $ K  Title  !"#$%&'()*+,-./0123456789:;<=>?@ABCDEFGHIJKLMNPQRSTUVXYZ[\]^aRoot Entry F@>.c1TablecWordDocument48SummaryInformation(ODocumentSummaryInformation8WCompObjr  F Microsoft Word 97-2003 Document MSWordDocWord.Document.89q