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Our Hospital
Our Doctors
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Hospital Tour
Careers
Services
Wellness Exams
Dental Care
Vaccinations
Microchipping
Spay & Neuter
Senior Wellness
Surgery
In-House Laboratory
Happy Visit Mondays
View All Services
New Clients
Payment Options
News
Donate to Paisley Paws
Download Our App
Clinic Policies
COVID-19
Does Your Pet Have Heart Disease?
Shop Online
Contact Us
Make An Appointment
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Heartworm Preventative Waiver
Heartworm Preventative Waiver
Preventative 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’s Recommendation is:
(Required)
Client's Phone Number
(Required)
I herby decline
(Required)
Heartworm test
Heartworm preventive
I hold both veterinarian and staff harmless should illness, injury, or death result from declining the recommended care.
Pet Name
(Required)
Veterinarian
Pet Owner's Name
(Required)
Date
(Required)
MM slash DD slash YYYY
Pet Owner's Signature
(Required)
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