.06 Written Approval from Humane Society or Animal Shelter.

Provided an animal upon which surgery is to be performed is owned by a humane society or animal shelter, and the surgery is to be performed in the humane society or animal shelter, the veterinary practitioner shall obtain written approval from the owner of the humane society or animal shelter before allowing the veterinary preceptee to perform any surgeries upon animals unassisted by the veterinary practitioner. This written approval may cover the entire period during which the veterinary preceptee is working under the responsible direct supervision of a veterinary practitioner. This written approval shall include, at a minimum, the following information:

A. Name of humane society or animal shelter;

B. A statement which indicates the following:

(1) The number of years successfully completed by the veterinary preceptee at an AVMA-accredited school of veterinary medicine;

(2) That the veterinary practitioner providing responsible direct supervision to the veterinary preceptee is educationally, medically, and legally responsible for any medical, surgical, diagnostic, and therapeutic decisions made by the veterinary preceptee; and

(3) That any unassisted surgical procedures will be carried out only when the veterinary practitioner is providing direct supervision;

C. A statement that any and all questions about the work to be performed by the veterinary preceptee on the animals have been answered to the satisfaction of the shelter owner;

D. A statement or list of anticipated procedures to be performed that the shelter owner can either accept or reject;

E. The shelter owner's, or authorized agent's, printed name and signature;

F. The veterinary practitioner's printed name and signature; and

G. The date the written form is completed.