Consent for Vaccination Forms
Model 1 Consent for Vaccination
The goal of animal vaccination is to effectively reduce the extent and severity of infectious disease in our pets.
In granting this consent to vaccinate, I hereby state that:
- I understand that (cat’s name) may be exposed to (disease).
- I understand that (cat’s name) has a (state current best estimate of odds); chance of contracting (disease).
- I understand that vaccination of (cat’s name) with (state name & type of vaccine) will substantially reduce, but may not completely eliminate his/her chances of contracting (disease).
- I understand that (cat’s name) may develop (list side effects) within (state time frame of vaccination). I understand these side effects are usually minor and pass without the need for additional veterinary care. I understand that should (cat’s name) develop any severe or unanticipated reaction to the vaccination, I should contact (state who to contact and how) immediately for instructions.
- I understand that (cat’s name) has a (state current best estimate of odds) chance of developing a fibrosarcoma-type tumor at the vaccination site. I understand that this type of tumor, should it occur, is life-threatening and may require extensive medical or surgical treatment.
- I have had an opportunity to ask any questions I have concerning this vaccination. All such questions have been answered to my satisfaction.
I hereby consent to have my cat vaccinated for (state disease).
I have read and understood to my satisfaction the materials provided to me by Dr. (state name). The doctor has answered to my satisfaction all of my questions.
I am aware of the significant risks and benefits of vaccinating (state cat’s name) against (state disease).
© 2021 California Veterinary Medical Association