I, the owner or authorized agent for the owner of the above mentioned patient, hereby acknowledge that the doctor(s) at Happier At Home Mobile Veterinary Hospital are recommending that he/she receives specific treatments/procedures based on medical need(s). In spite of the nature of his/her condition, I am declining any/all medical treatments/procedures at this time. I fully recognize that this release is against the doctor's recommendations.

I understand that the above mentioned patient requires further medical attention and that it is my responsibility to seek such care. In the event any adverse medical problems (including death) occur because of declined treatments/procedures, I accept full financial and medical responsibility for my decision and hereby release Happier At Home Mobile Veterinary Hospital, its staff, and contracted agents from all responsibility and liability for that choice.

I understand that I am allowed to return for medical treatments/procedures at a later date as this is not a termination of the doctor-patient relationship with my pet.