Student Liability Waiver

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Animal Works Veterinary Surgery Veterinary Student Liability Waiver, Assumption of Risk and Indemnity Agreement

Owner's Name *

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Animal Works cares about providing opportunities for veterinary students to gain the hands-on surgical experience necessary to become practice ready for their future. The rescue above has agreed to allow students under Animal Works supervision to perform surgery on animals under the rescue’s care. The students will be accompanied by and under direct supervision of a licensed veterinarian during each procedure. I certify that I am, in fact, the authorized agent for the Rescue Group named above. I grant the veterinarians and staff of Animal Works Veterinary Surgery my consent to and authorization for procedures to be performed with veterinary students for any pet (unless specifically noted) my organization brings to Animal Works Veterinary Surgery whether at 1002 W. Drake Ft. Collins location or mobile. *

I understand and agree.

I understand and acknowledge that this release waives, discharges and covenants not to sue Animal Works Veterinary Surgery, its owners, directors, representatives, officers, agents, employees, contractors, subcontractors, successors, heirs, affiliates, veterinary students, and volunteers from any liability or claim that our organization may have against Animal Works Veterinary Surgery with respect to any and all loss, damage or cost including but not limited to; animal injury, illness, death, or property damage that may result from procedures performed at Animal Works. *

I understand and agree.

Assumption of Risks: Although every effort is made to train and supervise veterinary students, there are inherent, unavoidable, assumed risks with any surgical procedure, and results cannot be guaranteed. I understand the risks involved and I am encouraged to discuss any concerns I have about the risks with the management at Animal Works Veterinary Surgery before procedure(s) are performed. *

I understand and agree.

I understand that Animal Works Veterinary Surgery does not assume any responsibility for or obligation to provide our organization with financial reimbursement or other assistance and hereby agrees to indemnify and hold harmless Animal Works Veterinary Surgery, its owners, directors, representatives, officers, agents, employees, contractors, subcontractors, successors, heirs, affiliates, veterinary students, and volunteers from any and all loss, liability, damage or cost that may incur arising out of surgical procedure(s). *

I understand and agree.

This agreement shall be valid for the entire duration of our business relationship with Animal Works Veterinary Surgery. *

I agree that a digitally scanned or photographic copy of this authorization and instruction shall be as valid as the original.

Digital Signature *

Date *

Student Liability Waiver

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