Prescription Waiver

You have requested a written prescription to purchase medication or prescription diet from an online or retail pharmacy for the listed patient.

The doctors and staff at Brighton Animal Clinic are committed to the health and safety or your pet. We request this waiver be signed for a Release of Liability. Brighton Animal Clinic cannot take responsibility for medications or foods purchased outside our facility. By signing this document, you acknowledge that we have informed you of the following:

Purchasing prescription medications or food from an internet pharmacy may be associated with risks.
The National Association of Boards of Pharmacy advises consumers to be aware of issues associated with some online pharmacies. This may include not adhering to regulations that guarantee authenticity, quality, safety, purity, expiration dates, shipping, proper storage or origin or sourcing of prescriptions or food.
Purchasing through a licensed Veterinarian insures that all manufacturer warranties and refunds are honored (not voided because of purchase source).
Our clinic online pharmacy offers competitive pricing and our in clinic pharmacy provides immediate access to needed medications and food for your pet. Our clinic provides individualized medical advice and treatment plan for your pet.

By your signature, you agree to hold Brighton Animal Clinic harmless in this matter. Once a signed waiver is received, we will prepare a written script for the appropriate medication or diet. This may take 24-48 hours. We will notify you once it is ready for pick up. Please refer to our pharmacy policy on our website or posted in clinic. This waiver is valid for 1 year from date of signature.

Client Name

First Name

Last Name

Name of Pet

Phone

(###)

###

####

Waiver Acknowledgement

Decline

Pharmacy Waiver

You have requested a written prescription to purchase medication or prescription diet from an online or retail pharmacy for the listed patient. The doctors and staff at Brighton Animal Clinic are committed to the health and safety or your pet. We request this waiver be signed for a Release of Liability. Brighton Animal Clinic cannot take responsibility for medications or foods purchased outside our facility. By signing this document, you acknowledge that we have informed you of the following: **Purchasing prescription medications or food from an internet pharmacy may be associated with risks. **The National Association of Boards of Pharmacy advises consumers to be aware of issues associated with some online pharmacies. This may include not adhering to regulations that guarantee authenticity, quality, safety, purity, expiration dates, shipping, proper storage or origin or sourcing of prescriptions or food. **Purchasing through a licensed Veterinarian insures that all manufacturer warranties and refunds are honored (not voided because of purchase source). **Our clinic online pharmacy offers competitive pricing and our in clinic pharmacy provides immediate access to needed medications and food for your pet. Our clinic provides individualized medical advice and treatment plan for your pet. By your signature, you agree to hold Brighton Animal Clinic harmless in this matter. Once a signed waiver is received, we will prepare a written script for the appropriate medication or diet. This may take 24-48 hours. We will notify you once it is ready for pick up. Please refer to our pharmacy policy on our website or posted in clinic. This waiver is valid for 1 year from date of signature.