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Wolf Hybrid Rabies Vaccination Consent Form

OWNER REQUEST FORM FOR RABIES VACCINATION OF
A WILD ANIMAL OR WILD ANIMAL HYBRID.

I request that my ____________________________________ (species), a wild animal or wild animal hybrid, receive an inactivated (killed virus), rabies vaccine.

Animal Name ______________________________________ Age ______ Sex ______

I further acknowledge that I have been advised by the attending veterinarian of the following:

  1. While inactivated rabies vaccines have been proven effective in domestic animals, their effectiveness in wild animals or their hybrids has not been tested, and therefore, is unknown.
  2. Because the effectiveness is unknown, there may still be considerable risk of vaccinated wild animals or their hybrids contracting rabies if exposed (bitten) by a rabid animal.
  3. Because the effectiveness is unknown, there may still be considerable risk to humans who come in contact with vaccinated wild animals or their hybrids that have been exposed to rabies.
  4. Because the effectiveness is unknown, a wild animal or its hybrid that bites a human will be considered non-vaccinated, regardless of its vaccination history. The recommendation in such cases would be to sacrifice the biting animal and examine the brain for rabies.
  5. Because the effectiveness is unknown, a wild animal or its hybrid that bites another animal will be considered non-vaccinated, regardless of its vaccination history. The recommendation in such cases depends on the animal bitten and its vaccination history, but the appropriate action could be to sacrifice the biting animal and examine the brain for rabies.

OWNERS
SIGNATURE                                                                                                                                            

DATE                                                                                     

ADDRESS                                                                                                                                                

WORK PHONE _________________________

HOME PHONE _________________________

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