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Cape Fear Cane Corso, LLC
9205 Old River Rd
Burgaw, NC 28425
Release and Assumption of Risk of Puppy Ear Crop Procedure

I understand that ear cropping is a surgical procedure that has some risk involved which can
include death of puppy.
I also understand that there are potential risks of which I may not
presently be aware.

I assume full responsibility and assume all risk and release Cape Fear Cane Corso, LLC

and Vicky Glisson from all liability.
The ears will be tender so pain medications will be administered. Keep ears dry. The sutures should be removed in about 10-14 days.
There is an increase in anesthetic risk with young puppies. Anesthetic death is a
possible outcome. Risk is minimal.
Certain vaccines are administered prior to this surgery.
Puppies this age are extremely susceptible to parvo enteritis (and other things) in which
case Cape Fear Cane Corso, LLC is not responsible if puppy becomes ill with the virus or other illnesses. Cape Fear Cane Corso, LLC has taken every precaution to prevent virus and disease in our kennels as well as administering initial Parvo vaccine prior to ear crops.
With every precaution in place, there are still chances of puppies becoming sick and/or
dying either directly or indirectly from ear crop surgery.

I hereby certify that I have read and fully understand this authorization for treatment. I am
the owner or agent for the above-described animal and have the authority to execute this
consent. I assume financial responsibility for all charges incurred to the above patient and
agree to pay all such charges when the animal is released from the hospital. I understand
that in the event of an emergency my pet will have treatment provided at my cost and I will
be contacted as soon as possible. I understand that any procedure, especially anesthesia,
involves some risks and results cannot be guaranteed.

Standard Consent Form for Anesthesia and Surgeries

As the owner or agent of the above pet, I hereby give consent and authorization for the performance of the following operation and procedure: EAR CROPPING

I have been advised the anesthetics carry some risks and results cannot be guaranteed.

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