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Off-Label Medication Consent Form
By Dr Duncan Houston
A free fillable consent form for off-label (extra-label) medication use, for veterinary practice. Record the medications, sign on screen, then print or download as a PDF. Nothing you enter is stored or sent anywhere.
Clinic Details
Client's Details
Patient's Details
About Off-Label Use
Many medications used in veterinary medicine are used "off-label". This means the use falls outside what the product is registered for: a different species, condition, dose, route, or duration, a human-registered product, or a compounded preparation. Off-label use is common, and lawful when directed by a veterinarian, but registered safety and efficacy data may be limited for this particular use and side effects may be less predictable than for on-label use.
Medications
Medication 1
Consent
I understand that the medication(s) listed above are being used off-label for my animal, and the veterinarian has explained why this use is recommended, the expected benefits, and the possible side effects. I agree to give the medication(s) only as directed, to monitor my animal, and to contact the clinic promptly if I see unexpected signs or side effects. If this animal is a food-producing species, I understand that withholding periods apply as directed by the veterinarian and that produce from this animal must not enter the food chain during them. I confirm that I am over the age of 18 years and am the owner, or an authorised agent of the owner, of this animal.
Owner / agent signature
Veterinarian signature
Built by Dr Duncan Houston for ASK A VET™ · askavet.com
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Nothing typed into this form is sent to or stored by askavet.com. All data stays in your browser and leaves only in the PDF or printout you create. Off-label prescribing rules differ by jurisdiction and species, especially for food-producing animals. The prescribing veterinarian is responsible for the recommendation and directions recorded on this form.