Before allowing a veterinary preceptee to perform surgery on a patient unassisted by the veterinary practitioner, the veterinary practitioner shall obtain written approval from the client. This written approval shall include, at a minimum, the following information: Client's name; Pet's name; A statement which indicates the following: The number of years successfully completed by the veterinary preceptee at an AVMA-accredited school of veterinary medicine; 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 That any unassisted surgical procedures will be carried out only when the veterinary practitioner is providing direct supervision; A statement that any and all questions about the work to be performed by the veterinary preceptee on the client's pet have been answered to the client's satisfaction; A statement or list of procedures to be performed that the client can either accept or reject; The client's, or authorized agent's, printed name and signature; The veterinary practitioner's printed name and signature; and The date the written form is completed.