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Heartworm Disclaimer

    • The effect of monthly heartworm preventative is to prevent the development of heartworm larvae into adult worms. Preventatives are not always 100% effective. Theoretically, even if only one pill is missed, it is still possible to develop the disease.

    • Therefore, we strongly recommend that your dog(s) be tested annually, even though he/she/they is/are on heartworm preventative year-around. If the preventative medication is administered to a heartworm positive dog, the results could be fatal. Additionally, anesthesia administered to a heartworm positive dog could also be fatal.

    • I have read and understand the above information, and I have chosen to forego the annual heartworm test on my dog(s). I understand that administering heartworm preventative or anesthesia is solely at my own risk, and I will not hold Drs. Chapman, Nolan, Thayer, Wilson, nor The Small Animal Clinic at Piedmont Equine responsible for any adverse affects.

    • Authorization

    • Date Format: MM slash DD slash YYYY