I, the undersigned, acknowledge that I am assuming all risks associated with the use of GS-441524, or any other drug or supplements provided through www.charlieshope.com. I understand that these risks may arise from negligence on the part of the persons or entities being released, as well as from the use of ineffective products, whether prepared, owned, maintained, administrated, or controlled by them, or due to their potential liability without fault.
I certify that any drug obtained through charlieshope.com is exclusively intended for administration to animals and is strictly prohibited for human use. Furthermore, I commit to coordinating all treatments with an FIP Warriors® administrator team, my veterinarian, and Dr. Federica Scaletti.
I am aware that side effects, including but not limited to pain at the injection site, rashes, skin irritations, open sores/wounds, allergic reactions, and even death, may occur when the product is used as described in this publication.
I acknowledge that: i) cats and other species diagnosed with Feline Infectious Peritonitis (FIP) or FIP-like disease have a nearly 100% mortality rate; ii) the drugs obtained through charlieshope.com are not approved by the FDA; therefore, they are intended for compassionate use or research purposes only, and risks are associated with the use of unregulated and not GMP certified products.
I understand that charlieshope.com and its volunteers are not qualified medical practitioners and are not responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific activity on their behalf. I acknowledge that this Release of Liability and Consent Form will govern my actions when using this product and will be utilized by charlieshope.com and its volunteers.
In consideration of my intention to use the drugs provided through charlieshope.com, as described in the literature, I hereby take the following actions for myself, my executors, and assigns: a) I waive, release, and discharge from all liability, including but not limited to, liability arising from the negligence, administration, or fault of the entities or persons released, for the death, disability, injury, or actions of any kind that may occur upon the use and/or administration of this product. b) I indemnify, hold harmless, and promise not to sue charlieshope.com and the entities or persons mentioned in this paragraph from all liabilities or claims made as a result of the use of any drug or supplement obtained, whether caused by the negligence of release or otherwise.
I certify that: 1) I was informed about other options of treatment through my veterinarian, 2) I am not able to afford treatment through my veterinarian and my cat would be otherwise euthanized, 3) I am not required to pay anything, other than the shipping cost, in exchange of the medication.
I have read and understand this document. I am aware that this is a release of liability, and my signature constitutes a binding contract. By signing below, I confirm that I have read and understood the information provided in this consent form.
