Heartworm Waiver – Manchaca Village Veterinary Care.

Our doctors follow the American Heartworm Society’s heartworm usage guidelines. The protocol is to maintain prevention at the required intervals, as well as require annual testing to guarantee effectiveness. There are serious health risks associated with forgoing heartworm treatment and testing, which is why we require your consent if you decide to waive the treatment.*
- I understand that my pet is at risk to contract heartworm disease, and it could be fatal..
- I understand that the recommended annual heartworm test could detect heartworm disease in my pet, even if my pet is currently on heartworm prevention.
- I understand that if I decline my pet's heartworm test today, the manufacturer's heartworm prevention guarantee becomes null and void..
I am declining the following:*
- Heartworm test
- Heartworm preventative
Pet Owner's Name*
First Last
Pet's Name*
By initialing below, I acknowledge the risks and am declining the veterinarian-recommended heartworm prevention and/or test.*
Today's Date*
Date Format: MM slash DD slash YYYY

Ready to see our Vets? Request Appointment