COMMUNITY DOGS
SPAY/NEUTER WAIVER.

Community Dogs Spay/Neuter Waiver Form

Please do not complete this waiver until you have completed our Community Dogs Spay/Neuter Request Form.

I, the undersigned, certify that I am the legal owner of this/these dog(s) named:

I temporarily release my dog to Twin Oaks Veterinary Hospital through Ramapo-Bergen Animal Refuge, Inc. (RBARI) Community Dogs Spay/Neuter Program for the purpose of performing the spay/neuter surgery, other procedures necessary for the proper performance of spay /neuter surgery (the “Spay/Neuter Procedure”), vaccinations, or other needed medical treatments approved and scheduled for the wellbeing of this animal. I understand that, as with any surgical procedure, the Spay/Neuter Procedure is performed with the risk of medical complications or death, and I agree not to hold RBARI and the veterinary hospital performing the Spay/Neuter Procedure responsible for any injury, illness, or for the death of my dog resulting from the Spay/Neuter Procedure. I further agree to waive any and all claims against RBARI or the veterinary hospital performing the Spay/Neuter Procedure, for any injury, illness, or for the death of my dog, resulting from the Spay/Neuter Procedure, including but not limited to any injury or any injury, illness, or for the death of my dog caused by any alleged negligence or wrongdoing on the part of RBARI or the veterinary hospital performing the Spay/Neuter Procedure.

I agree to be responsible for any additional fees not related to the Spay/Neuter Procedure including, but not limited to, any necessary vaccines, or for the treatment of any unrelated conditions that may be detected on exam by the veterinarian (i.e. parasites, ear, skin, eye or infections, flea infestation, etc.) unless otherwise agreed upon by RBARI in writing.

I agree to pick up my dog(s) from Twin Oaks on the agreed upon date and time. Failure to reclaim my dog on the agreed upon date will be considered abandonment. Animal abandonment is a crime and a fine of up to $1,000 can be charged.

In the event of a sudden emergency where you are not able to make your appointment, you must call or text RBARI’s Outreach Line by 4:00 pm the day prior at 551-296-5600. Should I have any questions, I will email outreach@rbari.org.

Please select the treatments below along with the non-refundable fees due upon submission of this form for the scheduled appointment. Until the form and payment are submitted, I understand that my dog will not be put on the schedule for surgery. Appointments are made and coordinated solely by RBARI.

The Night Before

It is important to remove all food at or before midnight the night before surgery so that they have an empty stomach when they arrive at Twin Oaks. They are allowed to have water up until they are dropped off, but no food the night or morning of.

Drop Off

Twin Oaks Veterinary Hospital

328 Teaneck Rd

Teaneck, NJ 07666

*RBARI will not be able to reschedule your appointment. Ensure that you have prepared timely transport on the day and time you are scheduled.*

• Drop off for owners at Twin Oaks is between 9-9:30 am. It is essential that you are on time for your drop off.

• Dogs must be brought in on a secure collar or harness and leash. If deemed necessary, the dog must also be muzzled prior to arrival to the hospital as well.

Pick Up

• When the animal is ready for pick up, Twin Oaks will reach out to owners via the contact information provided to RBARI to let them know they are ready.

• Twin Oaks will review discharge instructions with you and will also hand a copy of it when you come to pick up.

By digitally signing below, I agree to the terms of this agreement and nonrefundable fees due at this time.