This form certifies that I am requesting the release of my pet from Veterinary Emergency Treatment Services & Specialty (VETSS), against the advice of the veterinarian and medical staff. I choose to decline any further diagnostics/treatments/hospitalizations that are being recommended to me by the staff at VETSS. The medical benefits/risks have been explained by a veterinary staff member. I understand that these risks could include further pain and suffering, and potentially death. I have been advised that other unknown complications/risks are also possible. I assume full responsibility connected with this action, and hereby release Veterinary Emergency Treatment Services & Specialty, and its staff, of all liability or medical claims resulting from my refusal for further medical care for my pet. I agree and understand that by typing my name below, all electronic signature are the legal equivalent of my signature and I consent to be legally bound to this agreement.