"*" indicates required fields CommentsThis field is for validation purposes and should be left unchanged.Veterinary Prescription Disclosure: According to Florida CS/CS/HB 89 regulation, our practice is required to inform clients of the right to receive a prescription medication from Coastal Animal Medical Center or a written script to be filled at a pharmacy of your choice. This disclosure form acknowledges that you have been informed of your rights. This requirement does not apply in emergencies requiring immediate medication to prevent suffering or save an animal’s life, or in cases involving certain controlled substances restricted by law. ACKNOWLEDGMENT OF PRESCRIPTION MEDICATION OPTIONS I, the undersigned, understand the policies written above and have no further questions.Name* First Last Signature*Date* MM slash DD slash YYYY
