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Our emphasis is on insuring that your pet is fully protected from all preventable diseases. That means
always doing all we can to insure all products used are handled in the proper manner and prescribed only
for pets that have been examined by a veterinarian. Medications and biologicals are of particular concern
because of their fragility.

We acknowledge that heartworm products and flea preventatives are expensive and that cost savings
are important. We want to provide you with information so that you can make the right decisions
regarding your pet’s health.

    •    Our primary concern is that the medications may not be handled properly to prevent
         overheating/freezing, which would render the product ineffective.

    •    Merial (the company that manufactures Heartgard and Frontline) will not honor the parasite free
         guarantee if products are purchased from online companies and no coupons or rebates can be used
         when purchasing these products online due to the diversion issues outlined below.

    •    Problems can occur for pets unless proper testing and consultation occur before administration of
         these products. Yearly testing is needed for early detection of heartworm disease even with pets on
         year-round medication and is necessary for Merial to honor their parasite-free guarantee.

For the following reasons we have concerns about products purchased from online pharmacies (1-
800 PetMeds, Drs. Foster and Smith, PetCare Rx, etc) and at this time will only fill prescriptions
after receipt of this signed form. These concerns are based on reports from 2002-2006 that indicated that
the Pharmacy Boards in Florida, Texas, Louisiana, and New Mexico disciplined one of our top three
concerning online pharmacies, Pet Med Express (now 1-800 PetMeds)

    1) Purchasing, dispensing, and distributing drugs not approved by the US FDA. (Allegedly
       heartworm products were being purchased from Australia).

    2) Pet Med Express (1-800 PetMeds) hired veterinarians to write prescriptions when they have not
       physically examined the animal for whom the prescription is written.

    3) Pharmacists employed by Pet Med Express (1-800 PetMeds) were placed on a 3-year probation,
       subject to community service.

These breaks of valid client-patient relationships could put pets at risk. We will write prescriptions to an
outside pharmacy whenever you wish for issues of convenience or cost as long as you are aware of the
afore mentioned risks. The Staff of Westside Family Pet Clinic’s primary concern is the good health of
your pet.

Be sure to continue using Heartgard and Frontline for dogs and Revolution for cats once-a-month year-
round as recommended by the CDC, CAPC, and American Heartworm Society. Please visit the following
websites for additional information:,, and

I have read the above                                                     Date__________________

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