Glucocorticoids Waiver

I hereby decline the blood work my veterinarian has recommended every 6 months in order to maintain my animal on prescription medication. I understand the medication my animal is taking may have harmful side effects after prolonged use. I understand the blood work recommended would alert me to any of those harmful side effects before the medication did any permanent damage.

Medication(s): Medrol, Prednisone/Prednisolone, Fluticasone aerosol.

Wellness testing recommended: MEDICATION MONITORING PROFILE – includes a chemistry profile, CBC (complete blood count) and urinalysis.

Recommended every 6 MONTHS

Risks associated with medication: elevated liver enzymes, GI ulceration, immunosuppression, iatrogenic Cushing’s disease and activation or worsening of diabetes mellitus.

Contraindications/Precautions: The above medication should not be given with other steroids or NSAIDS.

Discernable adverse effects: vomiting, diarrhea, increased drinking/urination, alopecia, muscle wasting, skin fragility and behavioral changes such as depression or lethargy.

I am aware of the consequences by not performing this blood work. My veterinarian or representative has spoken with me at length about these risks and has answered al of my questions regarding my pet’s condition and the medication. I will make my veterinarian aware if any of these adverse effects occur and understand that blood work may need to be done at that time.

Glucocorticoids Waiver
Pet Name
Pet Name
First
Last

Get the best care for your best friend.

Request an appointment online
Skip to content