Castration Form

Name: Rivers Equine Veterinary
Address: 2/3 Durrington St, South Murwillumbah, NSW, 2484, Australia
Telephone: (02) 6672 3898
Price range: $

Please fill out the form below.

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Castration Form

Please fill out this form as completely and accurately as possible.
If you have any questions, please call us at (02) 6672 3898.

Owner/Agent's Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Mobile Phone *

Phone

Fax

Email *

Horse's Name *

Age *

Colour *

Breed *

Sire

Dam

Microchip

Brands NS

Brands OS

I authorise The Rivers Equine Vet to administer a sedative and local anaesthetic or general anaesthetic for the above-described horse to be gelded. If an agent of the owner, I confirm that I have the owner's express authority to authorise the procedure. I confirm that my horse's insurance company/agent has been notified of this procedure. I acknowledge that no surgical or anaesthetic procedure is without some risk to the animal. I accept all potential surgical and anaesthetic risks, including any complications that may incur additional fees. I acknowledge that I have been made aware of the common potential complications of this procedure. I acknowledge that post-operative care may be required and undertaken as deemed necessary by the attending veterinarian. I undertake to pay all costs incurred in undertaking this procedure. *

I agree.

Signature of Owner/Agent *

Date *

Castration Form

Castration Form

Ready for us to see your horse?

Office

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Phone & Email

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