I, (name, fill below), the undersigned owner or authorized agent for the owner of (pet name, fill below), acknowledge that use of antibiotics without proper testing to confirm that the medication is needed could cause potential problems for test dog in the future. It was explained and recommended to me that diagnostic testing before use of antibiotics is strongly recommended. I fully recognize that my decision is against the attending doctor's recommendations. I accept full financial and medical responsibility for my decision and hereby release the staff at this veterinary practice of all responsibility and liability for that choice.