CLINIC HQ

8.7.1. Verbal High-Risk Waivers

Verbal High-Risk Waiver

First, it should be noted to use these tools, your clinic must be using Patient Flow. These tools are only available in Patient Flow.

HQ automates collecting high-risk waivers through workflows for verbal or email consent (see next section). The ASPCA Spay Neuter Alliance uses verbal waivers for owners, shelters, and transport partners. Your clinic may follow this model or adapt it with a witness present.

For the verbal high-risk waiver, staff calls the owner, reads a customized script with the waiver’s specific reasons, and records whether the owner accepts or declines. An optional setting requires a witness’s initials before moving forward with the decision.

Steps to Issue a Verbal High-Risk Waiver

  1. From Patient Flow, click on Exam & Premed screen, in Exam column, click the Normal button. This button is the path to everything related to the exam of an animal.
  2. From the Exam screen, click Request High-Risk Waiver button.
  3. Next, click the reasons for requesting the high-risk waiver. If the reason is Other, there is a text box on this screen to specify findings. Once finished, click the Done button at the bottom of the screen.
  4. Once the Request High-Risk Waiver button has been clicked, the patient is put under the HRW tab in Patient Flow. In HRW tab, the reason(s) for the requested high-risk waiver are noted under the patient and highlighted in yellow to the right under the Action column.
  5. Select the Verbal’ button on the right in the Action column.
  6. Next, you’ll note a script pops up for you to read to the client. The script is editable in Settings. The staff member’s name will automatically be input based on their login information. If you have elected to require a witness to approve or deny a verbal high-risk waiver, they must manually enter their name or initials in the Witness Name text box. In this example, two reasons have been indicated for the High-Risk Waiver. The blurb of text that goes with the waiver is set up in Settings.
  7. The Call Log text box is a place to note if staff has attempted to call a client and they were unreachable. Utilizing this tool is helpful so that any staff can log in and see a report of attempted calls, messages left, or any other correspondence.

Note: Your clinic sets up high-Risk Waiver reasons in Settings> Medical Notes. They are highly customizable. See the instructions here for setting them up.


  1. To Accept or Decline the High-Risk Waiver, click the ‘Confirm HRW’ button at the bottom and select either “Owner Accepted” or “Owner Declined.” If the client accepts, you will be required to click
    the “yes” button confirming that you read the client the script as well as to confirm the acceptance of the High-Risk Waiver. The system will automatically do the following:
  • Turn the HRW tag green in all places to indicate it was accepted.
  • Please make sure you save the High-Risk Waiver on your computer.
  • However, one of the best things it does, is auto uploads the same document to the documents section for this patient. You do not have to do anything to get it to auto-upload (other than save it).
  • HQ will then remove the patient from the HRW screen.

If the owner declines the high-risk waiver, the HRW tag will turn red and the surgery will be declined. HQ will also input the reason for the declined surgery as the Owner declined the High-Risk Waiver.