Skip to content
Home
About Us
Meet Our Team
Services
Pet Care Services
Flea Prevention and Control
Heartworm Prevention
Tick Prevention
Nail Trim Puppies and Kittens
Vet-Recommended Pet Food, Supplements and Treats
Pain Management and Control
Vaccinations
Microchip Pet Identification
Medical Services
Physical Exams
Dermatology
Cardiology
Medical Assessment
Gastroenterology
Respiratory Medicine
Hepatobiliary and Pancreatic Diseases
Endocrinology
Ophthalmology
Dentistry
Neurology
Infectious Disease
Nutrition
Hematology and Immunology
Diagnostics
Blood Test
Urinalysis
Urine Culture Testing
Abdominal Ultrasound
Fecal Test
Rabies Titer Testing FAVN
Cardiac Pro-BNP Testing
Skin Scraping
Ear and Skin Cytology
Aerobic and Anaerobic Culture and Sensitivity Testing
FNAC Fine Needle Aspiration Cytology
Biopsy Histopathology
Serum Allergy Testing
ECR Testing Respiratory Diseases
Echocardiogram
Addison and Cushing Disease Testing
FLEV and FIV Testing for Cats
Pancreatitis Testing Dogs and Cats
Titer Testing
Parasitology
Surgeries
Eye Surgery
Spaying
Neutering
Soft Tissue Surgery
Orthopaedic Surgery
Tumor Surgery
Enterectomy
Gastrotomy
Cystotomy
Splenectomy
Exploratory Services
Dental Services
Dental Cleaning
Dental Scaling
Dental Prophylactic Care
Dental Extractions
Urgent Care
Pyometra
Orthopaedic and Wound Repair
Foreign Body Removal
Trauma and Accident Care
Allergic Reactions
Heatstroke
Limping
Biopsies
Lacerations and Wound Care
Wellness Services
Puppy Wellness
Kitten Wellness
Adult Pet Wellness
Senior Pet Wellness
Nutrition Counselling
Nurturing Puppies and Kittens
Senior Pet Nutrition Counselling
Dogs and Cats Nutritional Counselling
Euthanasia
Communal Cremation
Private Cremation
Memorial Products
Pet Fur Preservation
Jewellery and Showpieces
Home Euthanasia
Medical Grooming Services
Demating Cats
Sedated Lion Shaving Cuts
Sedated Nail Trim
Additional Services
Pharmacy
Veterinary Specialist Referrals
Pet Travel Document
Pet Resources
ASPCA Pet Poison
White Rock Dog Licence
Apply For Financing
Pet Insurance
Pet Travel
Pet Food Alert
Product Alert
Online Store
Contact Us
Book an Appointment
New Client Registration
Medical Records Release Form
Medicine Refills and Food Orders
Authorization for Treatment
Vaccine Waiver
Home
About Us
Meet Our Team
Services
Pet Care Services
Flea Prevention and Control
Heartworm Prevention
Tick Prevention
Nail Trim Puppies and Kittens
Vet-Recommended Pet Food, Supplements and Treats
Pain Management and Control
Vaccinations
Microchip Pet Identification
Medical Services
Physical Exams
Dermatology
Cardiology
Medical Assessment
Gastroenterology
Respiratory Medicine
Hepatobiliary and Pancreatic Diseases
Endocrinology
Ophthalmology
Dentistry
Neurology
Infectious Disease
Nutrition
Hematology and Immunology
Diagnostics
Blood Test
Urinalysis
Urine Culture Testing
Abdominal Ultrasound
Fecal Test
Rabies Titer Testing FAVN
Cardiac Pro-BNP Testing
Skin Scraping
Ear and Skin Cytology
Aerobic and Anaerobic Culture and Sensitivity Testing
FNAC Fine Needle Aspiration Cytology
Biopsy Histopathology
Serum Allergy Testing
ECR Testing Respiratory Diseases
Echocardiogram
Addison and Cushing Disease Testing
FLEV and FIV Testing for Cats
Pancreatitis Testing Dogs and Cats
Titer Testing
Parasitology
Surgeries
Eye Surgery
Spaying
Neutering
Soft Tissue Surgery
Orthopaedic Surgery
Tumor Surgery
Enterectomy
Gastrotomy
Cystotomy
Splenectomy
Exploratory Services
Dental Services
Dental Cleaning
Dental Scaling
Dental Prophylactic Care
Dental Extractions
Urgent Care
Pyometra
Orthopaedic and Wound Repair
Foreign Body Removal
Trauma and Accident Care
Allergic Reactions
Heatstroke
Limping
Biopsies
Lacerations and Wound Care
Wellness Services
Puppy Wellness
Kitten Wellness
Adult Pet Wellness
Senior Pet Wellness
Nutrition Counselling
Nurturing Puppies and Kittens
Senior Pet Nutrition Counselling
Dogs and Cats Nutritional Counselling
Euthanasia
Communal Cremation
Private Cremation
Memorial Products
Pet Fur Preservation
Jewellery and Showpieces
Home Euthanasia
Medical Grooming Services
Demating Cats
Sedated Lion Shaving Cuts
Sedated Nail Trim
Additional Services
Pharmacy
Veterinary Specialist Referrals
Pet Travel Document
Pet Resources
ASPCA Pet Poison
White Rock Dog Licence
Apply For Financing
Pet Insurance
Pet Travel
Pet Food Alert
Product Alert
Online Store
Contact Us
Book an Appointment
New Client Registration
Medical Records Release Form
Medicine Refills and Food Orders
Authorization for Treatment
Vaccine Waiver
+1 (604) 536-3131
+1 (604) 536-3131
Vaccine Waiver
First Name
Last Name
Mobile Phone
Email
Pet's Name
Vaccines are intended to prevent and protect against disease. We only vaccinate pets who are not exhibiting any signs of illness. If your pet has had any recent episodes of illness (including but not limited to vomiting, diarrhea, sneezing, coughing, wheezing, lethargy, fever, weight loss, and dehydration), please notify one of the staff members. As with any medical procedure, vaccinations are NOT risk-free. Although rare, product(s) may produce allergic reactions and/or anaphylaxis.
The severity of a vaccine reaction can vary from pet to pet.
Emergency treatment for anaphylaxis may be needed immediately and up to 72 hours after receiving vaccinations.
In the event Peace Arch Veterinary Hospital needs to medically intervene for my pet, I agree to pay in full at the time of treatment.
Please inform Peace Arch Veterinary Hospital of any previous allergic reactions or episodes of anaphylaxis prior to your pet being vaccinated.
After-hours observation is not provided by Peace Arch Veterinary Hospital. In the event your pet requires care for anaphylaxis, it is your responsibility to seek further treatment at an after-hours emergency facility.
I understand that my pet may have a reaction to a vaccine. In the event my pet needs emergency treatment, I release Peace Arch Veterinary Hospital from all liability, as well as any responsibility for medical bills incurred.
To the best of my knowledge and belief, this animal has not bitten any person during the fifteen days preceding this date.
Signature
Submit
Scroll to Top