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Print this form for use in the veterinary practice.

 

Offering Behavior Services 

Informed Consent Regarding Treatment

for an Aggressive or Destructive Pet 


Client Name:                                                                                

Home Phone number:                                                      

Name of Animal:                                                           

I certify that I am the owner of the above-described animal. I have requested advice from consultants of the service Animal Behavior Network (Veterinary Telecommunications) regarding decreasing my pet’s aggressiveness or destructiveness.

I understand that aggression by animals can cause injury, including fatal injury, to other animals, to property, other people and to me. I understand that treatment for aggressive behavior is an inexact science, and it is impossible to insure that my pet will not cause harm in the future.

I understand that the only way to insure that my pet will not cause harm in the future is to euthanize it. I understand that if I do not euthanize my pet, it will be my responsibility to take appropriate precautions to prevent my pet’s causing harm. These precautions may include, but are not limited to, informing persons responsible for pet sitting or boarding about the possibility of aggression or destruction, persons near my pet of its proclivity for aggressive behavior, keeping it on a leash, muzzled, and/or keeping it restrained behind doors, gates, or fencing. I also understand that it is my responsibility to be aware of and to comply with all state and local ordinances concerning aggressive animals. Finally, I understand that, should I choose not to euthanize my pet and it causes harm in the future, I may be held liable for such harm.

This agreement confirms I am aware that my animal may be put onto behavior medications intended to modify its response. This medication may be “off-label” use with no specific research available on safety or potential drug interactions. I understand in some cases this medication may have no effect, or even make the behavior worse instead of better. If so, I agree to contact the consultant to inform them of this status.

I agree that if this pet does cause harm to any property, person or other animal, I accept full responsibility, and agree to hold harmless the ABN consultant and associates, and any veterinarian or vet staff involved.

I certify that I have read and understood the above and that I am signing this authorization with the full understanding that the treatment given my pet may not eliminate its destructive or aggressive behavior.


Signature of Pet Parent:
                                                           


Printed Name:                                                           


Date:
                                                           

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