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1556 S. Michigan Avenue, Ste.100, Chicago, IL 60605
(312) 583-1921
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Heartworm Test Waiver
Heartworm Test Waiver
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Consent
I understand that it is possible to get heartworms even if on monthly preventative. This can be caused by missing a dose, vomiting up medication unbeknownst to owner, inappropriate dosing or rarely, product failure.
Consent
I understand that giving certain heartworm preventatives to a dog that is positive for heartworms may cause serious illness up to and including death.
Consent
I understand that by not annually testing for heartworms or by purchasing HW prevention from the internet, I will void any manufacturer’s compensation offered for treatment of heartworm disease.
I hereby waive the testing process and release the doctor and staff of Metropolitan Veterinary Center
from any and all liability for any reactions from giving heartworm medication to my dog without prior
testing. Any medications other than approved methods have not been evaluated for efficacy and as such
Metropolitan Veterinary Center resumes no responsibility for any adverse side-effects they may cause.
Signature of Owner
(Required)
Date
(Required)
MM slash DD slash YYYY
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