My Pet First Name Last Name has been diagnosed with a condition requiring long-term medication treatment to help maintain his/her quality of life.In order to ensure that the prescribed medications are being tolerated well by your pet's internal organs, periodic blood tests are strongly recommended by the drug manufacturers, as well as your pet's veterinarian. Prior to refilling certain medications, bloodwork is required.As the responsible party for First Name Last Name I Accept Decline the recommended testing and assume all responsibility for any adverse effects or reactions that may arise from continued therapy. Signature Date