PLEASE READ AND SIGN THIS
To the best of my knowledge, my pet(s) is healthy with no diagnosed allergies to vaccines and has had no recent occurrence of abnormal coughing, sneezing, vomiting, diarrhea or weight. My pet has not bitten or scratched anyone in the last 10 days. I have disclosed all medications my pet is on. I acknowledge the fact that a vaccine reaction is possible. Should it happen that my pet becomes ill due to a vaccination, I will not hold the Veterinarian or One Health Vet responsible as reactions are highly individual immune responses which cannot be foreseen.
A vaccine reaction is rare yet Potential side effects from vaccination include depression, muscle aches, stiffness, mild fever, or small lump at vaccine site. These side effects are usually temporary. Welts, facial swelling, vomiting, diarrhea, difficulty breathing, altered mental state, or shaking could be an allergic reaction. If any allergic reaction symptoms occur, proceed immediately to the nearest animal emergency facility.
FINANCIAL RESPONSIBILITY
I understand that unforeseen side effect/allergic reactions may occur in any animal after the injection of a ShotVet act only to install these vaccines produced by major manufacturers of animal health products. Any side-effects/ allergic reactions requiring further medical attention is at my own expense. Due to the nature of the clinic setting, free medical for vaccine-related side-effects and allergic reactions during clinic hours will be given but is limited, and my pet may require further treatment at my expense. All other post-vaccinial events requiring treatment will be at my own expense. I have been given the opportunity to ask any questions concerning this policy before signing below. Being aware of these facts, I give my permission to the Veterinarian to administer the vaccines and medications listed on this document. Fee for Written Prescriptions is $10 payable at the time of service.
YOUR PET HAS BEEN EXAMINED TO DETERMINE THE APPROPRIATENESS OF IMMUNIZATIONS SELECTED, THIS IS NOT A FULL AND COMPLETE
PHYSICAL EXAMINATION
I understand that as my pet’s healthcare provider, One Health Vet may remind me via email, snail mail and/or text (standard text messaging rates may apply) when my pet(s) are due for refills, shots, and other medical related treatments.
Medical records will be sent after services are completed through the email provided. If you do not receive your records within an hour please call 407-749-4469 to have them sent.
MEDIA RELEASE
I hereby grant and convey One Health Vet LLC and its authorized representatives all right, title and interest I may have in any and all photographs, video recordings, and other recording devices made during and around a visit to One Health Vet LLC place. I further agree that One Health Vet shall have the right to use such recordings for any and all purposes, an unlimited number of times and in perpetuity by any and all means and media, now and hereafter created.
A $10 prescription fee must be paid for at the time of the visit or when requested at a later time. When purchasing products from One Health Vet the prescription fee is included in the marked price of the product. For more information please ask one of our customer services representatives at the clinic 407-749-4469
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