Behavior Waiver Form

Behavior Waiver Form

Behavior Medicine Department General Waiver

Heart of Chelsea Veterinary Behavior Medicine Department General Waiver

Welcome to Heart of Chelsea Veterinary Behavior Medicine Service! We understand how stressful behavioral difficulties in our pets can be, and we are here to help. Our doctors have years of experience treating a wide variety of behavioral concerns – you name it, we’ve likely seen it (many times!) We understand how isolating and scary it can feel to have a pet with behavior concerns, but we are happy to let you know there are many options for treatments to help improve the quality of life for both your pet and your family.

Thank you for consulting with the Heart of Chelsea Veterinary Behavior Medicine Department about your pet. Dealing with training and behavioral disorders in pets can be very distressing, and we are honored that you have trusted us. Frequent communication and reasonable expectations are important when working on behavioral problems. Client participation will, to a large extent, determine whether your pet improves.

While improvements are common with many behavior and training problems, most behavior problems are not completely curable. For instance, if your pet is growling, hissing, swatting, snapping or biting, it is likely that even with treatment this behavior will occur sometimes in the future. You could be held solely legally and financially responsible for any injuries that your pet causes. You alone are responsible for avoiding situations that could result in injury.

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Please read and initial the following assumptions: 

We require in-person recheck visits every 6 months to maintain the veterinary client-patient relationship, to continue to offer advice (virtually or in-person), and to dispense medications. This allows us to assess your pets' progress with his/her behavioral conditions, discuss medication efficacy and adjust our plan as needed.
We generally expect most patients will require case follow up every 4-6 weeks when starting with behavior medicine department. This can be done in-person or virtually. The cost associated with these rechecks is listed below.
Many behavioral conditions are chronic conditions meaning they cannot be cured. The goal is to improve the quality of life for both your pet and your family. In some situations, despite behavioral therapy intervention, the condition will not improve.

What to expect at your initial appointment:

Our initial behavior appointment will be 90 minutes long. If your pet already has medications that you know help keep him or her calm during veterinary visits or in new locations, please give those medications 2 hours prior to leaving your home for your initial consultation. This is a long visit and we do not want your pet stressed the entire time.
WE DO NOT NEED TO SEE THE BEHAVIOR TO BELIEVE OR UNDERSTAND WHAT IS HAPPENING! We would rather your pet be as relaxed and comfortable as possible as we review the history and treatment plan. Many behavioral diagnoses and assessments are based off verbal history and discussion.

During our appointment we will: 

  • Briefly review the history form you will fill out below. 
  • Review your goal list (to assure we are all on the same page with what you hope to achieve) 
  • Review the behavioral diagnoses for your pet, as well as the prognosis and estimated timeline for improvement. 
  • If it is safe and comfortable for your pet, we will perform a physical exam. Otherwise, we will perform a distance exam to establish the legally required Veterinary Client-Patient Relationship (VCPR) 
  • Discuss a 3-part treatment plan: 
    • Medications and/or Supplements – if they are indicated for your pet, how and why they can make a difference, what we are looking for to indicate improvement, possible negative side effects or risks. 
    • Behavior Modification and Training – including recommendations for trusted trainers if you are not already working with one. We like to say that a behavior focused veterinarian is like the psychiatrist, and the trainer is the therapist. They often work as a team to help develop a comprehensive treatment plan for your pet. 
    • “Client Homework” – safety management and how to set your pet and their environment up for success. 

Please note we will always advocate for positive training methods, as science tells us this is by far the most successful long term. It is important to know that the success of your pet is directly dependent on your involvement and implementation of their treatment plan.

What to expect AFTER your initial appointment:

We know you might feel overwhelmed with information on your first visit, therefore, we will send you a treatment plan summary for you to reference after each appointment. In addition, we generally expect most families to require case follow up every 4-6 weeks. These visits will be virtual (by telephone) for 6 months from the date of your initial appointment.

Costs of Visits:

  • Initial Consultation - $1200
  • In Person Recheck - $475
  • Virtual Recheck - $325
  • Sedated Exam - An estimate of costs for this procedure will be provided by your doctor if this is indicated.

By signing this form you are indicating you understand that managing behavior problems involves inherent risk, and that you agree not to hold Heart of Chelsea, Dr. Andrea Y. Tu, Dr. Holly Memoli, or any other person or entity employed by or affiliated with the preceding persons or entities (collectively, “Releasees”), responsible for any injuries that may happen to you, other people, other animals or your pet during or following the course of treatment. Furthermore, you agree to identify and hold Releasees harmless from and against any and all third-party claims, damages, liabilities, actions, judgments, suits, costs, disbursements and expenses of any kind of nature, including, without limitation, reasonable fees and disbursements of counsel, that may be imposed on, incurred by or asserted or awarded against Releasees in connection with the treatment of your pet.