• Canine Vaccination Consent Form

  • Traditionally, veterinarians recommended that dogs receive annual vaccinations for  many diseases. Recent research and publications indicate that the yearly administration of vaccines for all diseases may not be necessary and may pose some health risks.

    Recommendations from many universities suggest that the timing of booster vaccines can vary from one to three years depending on the age of the pet, housing environment, region of the country, neighborhood in which the pet lives, and the specific disease the vaccine prevents.

    High-risk pets, such as those residing in kennels, participating in dog shows, being boarded frequently, or traveling extensively with their owners, may require more frequent boosters.

    • The DHPP vaccine that your dog has been given in the past protects against distemper, parvo, hepatitis, and parainfluenza viruses.
      • Distemper is a viral disease that can cause upper respiratory and gastrointestinal disease. Parvovirus causes severe gastrointestinal disease. Hepatitis is a virus that causes liver failure and gastrointestinal disease. All of the contagious viruses can be fatal, especially in young dogs, but occasionally in older ones too.
      • We recommend an initial DHPP vaccine series followed by a booster in one year.
      • We then recommend a booster vaccine every three years for dogs in a low-risk category.
    • Rabies is a viral disease that can be transmitted to people through infected saliva. It causes severe central nervous system signs and is fatal. 
      • The initial vaccine is given at 15 weeks of age followed by a booster in one year. Subsequent vaccines are good for three years. ($35.50) This vaccine is required by law.
    • Bordetella, or kennel cough, is a bacterial infection that causes upper respiratory symptoms. The immunity produced from the vaccine is not long-lasting and animals in some situations are more likely to be exposed.
      • We recommend an initial vaccine at 12 weeks of age followed by a yearly booster. ($35.00) 
    • Leptospirosis is a bacterial infection that dogs get from standing water contaminated with animals' urine. The infection can lead to kidney and/or liver disease and can be fatal. The bacteria is also transmissible to humans. There are several strains of Leptospirosis and our vaccine protects against the two most common forms. 
      • We recommend an initial vaccine series followed by a yearly booster ONLY if your dog is in a high-risk category.

    1. I elect to have my dog vaccinated for DHPP every three years ($29.50) based on age, health, breed, and exposure to disease as suggested by my dog's veterinarian. I agree to hold my veterinarian harmless in the event such effort to reduce the frequency and minimize known complications of vaccinations inadvertently increases my dog's risks of and fees related to treating any of the diseases for which a vaccine was not administered.

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  • 2. I elect to continue my dog's DHPP vaccine on a yearly basis ($29.50). I agree to hold my dog's veterinarian harmless in the event such compliance with traditional protocols and labeling laws inadvertently causes a medical complication associated with the use of the vaccine.

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  • 3. I elect to have my dog vaccinated for Leptospirosis ($27.00) on a yearly basis because he/she is in a high-risk category. I agree to hold my dog's veterinarian harmless in the event such compliance with traditional protocols and labeling laws inadvertently causes a medical complication associated with the use of the vaccine. 

  • Clear
  • 4. I elect to proceed with the following optional vaccines(s), based on my dog's current risk factors. I agree to hold my dog's veterinarian harmless in the event such compliance with traditional protocols and labeling laws inadvertently causes a medical complication associated with the use of the selected vaccine.

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