Written Prescription Waiver Form

By signing below, I acknowledge that Lifetime Pet Center of New Richmond does not recommend purchasing my pet's medications from outside or online pharmacies for the following reasons:

• The drug supply chain cannot be guaranteed. Medication could be counterfeit, improperly stored, or mislabeled.
• Medications supplied to online pharmacies could be illegally obtained.
• The safety and efficacy of medications supplied by online pharmacies cannot be guaranteed.

I also acknowledge that purchasing medications from outside or online pharmacies voids the manufacturer’s warranty. In the event the product fails or causes harm (including death), I understand that I have no recourse or refund for any harm that comes to my pet.

The U.S. Food and Drug Administration (FDA) recommends only purchasing medications from pharmacies that meet the following criteria:

• The pharmacy always requires a doctor’s prescription.
• The pharmacy has a physical address and telephone number in the United States.
• The pharmacy is licensed in the state(s) in which it operates.
• The pharmacy is licensed in all states where it conducts business.
• The pharmacy has a state-licensed pharmacist on staff to answer owner/patient questions.
• The pharmacy obtains all medications within the United States.

Lifetime Pet Center is providing me, the owner, with a written prescription for my pet's medication(s) to submit as I wish to any physical or online pharmacy I prefer. If I lose my written prescription, I understand there may be an additional charge to have it replaced. Lifetime Pet Center will not fax, send, or verbally authorize this prescription to limit liability in the event the medication is fraudulent, causes harm, or fails. By signing below, I acknowledge that I have read and understand the information above.