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Heartworm Prevention Waiver
Please review the information below and sign the preventive care waiver at the bottom of the screen.
Preventive Care Waiver
I understand that my dog/cat is at risk to contract heartworm disease.
I understand that if heartworm disease is contracted it could be fatal.
I understand that treatment for heartworm disease is not guaranteed and can cost up to $1,000 or more.
My veterinarian recommends year-round heartworm prevention to prevent new infections (does not treat established infections, "adult worms") and annual heartworm testing to detect any established infections.
I hereby decline
*
Heartworm Test
Heartworm Prevention
I hold both veterinarian and staff harmless should illness, injury, or death result from declining the recommended care.
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Indicates required field
Owner's Name
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First
Last
Pet(s) Name
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By typing your name electronically you are agreeing to the statements above and your electronic signature is the legal equivalent of your manual signature. PLEASE TYPE YOUR NAME:
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Wellness
Dog and Puppy Care
>
Dog Wellness
Puppy Wellness
Puppy Training Resources
Cat and Kitten Care
>
Cat
Kitten
Kitten Training Resources
Services
Dentistry
Diagnostic Imaging
Integrative Medicine
Laboratory Services
Medical Grooming
Surgery
Urgent Care
Euthanasia
Health Certificates
Resources
First Time Visit Information
Insurance & Payments
Pet Resources
Free Mobile App
Insurance & Payments
About Us
Our Location
Message Us
Meet The Dream Team
Join Our Team
Schedule Online