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Consent for Lab Tests and Provision of Medication Form

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Client's First Name*

Client Last Name*

Pet's Name*

I understand that a thorough history and physical examination is recommended prior to the initiation or continued use of medication therapy. I accept that to recognize problems that could occur and minimize them during treatment, doctors and staff at Gibraltar Veterinary Hospital have recommended screening my pet prior to treatment by performing laboratory tests to verify healthy organ function and establish baseline blood values and then to monitor changes in lab test results at intervals during long term treatment.

The need for these tests have been explained to me. I accept the costs incurred and authorize this facility to proceed with them and, if deemed appropriate, with the prescribed medication.

I understand

The need for these tests has been explained to me but I elect NOT to proceed because of the cost. Nonetheless, I consent to the provision of the prescribed medication.

I understand

Side effects that start out as minor problems can readily progress to emergencies. Because of this, I understand I am to report them to my attending veterinarian immediately or the next most available veterinary care facility.

I accept that veterinary medicine is an inexact science and that no guarantee of successful treatment has been made. I have read and understand the above information and accept the specific terms and conditions set forth herein. In the event I do not authorize the recommended pre-treatment blood analyses for my pet, fail to follow through with the periodic lab tests or fail to notify the attending doctor of the side effects, I agree to hold the attending doctor(s) and staff at this facility and the drug manufacturer harmless for any complications that might have been detected and/or avoided.

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