Hands 'N Paws Microchip Consent Form

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Personal Information

Additional Contact Information

Animal Information

Authorization and Agreement

I hereby authorize and direct Hands 'N Paws Animal Assistance to implant a microchip in my pet(s) listed above.  I fully release Hands 'N Paws Animal Assistance, its employees, and its agents from any legal and financial responsiblities, claims, demands, damages or actions arising from microchipping.  Furthermore, I accept that my pet(s) may develop side effects after microchip insertion and that I must examine the site of injection over the next week.  I understand that if my pet(s) develop any unanticipated problem following insertion of the microchip, it is solely my responsibility to seek veterinary care as needed or directed including any necessary veterinary care and the costs incurred thereof.


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