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Euthanasia Consent Form

Thank you for entrusting us with this deeply personal care for your pet. We are committed to supporting their comfort and dignity during this time and are here to support you in any way we can.

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Euthanasia Consent Form

Please fill out this form as completely and accurately as possible to allow us to proceed with your pet’s end-of-life care.

Name *

First

Last

pet provide care,

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Pet's Name *

Species *

Breed *

Color: *

Age: *

I, the undersigned, am at least 18 years old, and I am the owner / duly authorized agent for the owner of the animal described herein. I hereby consent to and order euthanasia (humane death) to be performed on this animal forever releasing saidveterinarian, hospital, and all agents from any and all liability for performing said euthanasia. It is my desire to provide for my pet decent and humane after-death care, complying with all legal requirements of the area. I authorize the attending veterinarian to now dispose of the remains in accordance with hospital policy, releasing the hospital, veterinarian and agents from any and all liability for performing after-death care, with the following stipulations included: *

I verify that the above stated pet has not bitten any person or animal during the last fourteen (14) days and to the best of my knowledge has not been exposed to rabies. *

I agree

Signature *

Clear Signature

Today's Date *

Message

Euthanasia Consent Form

Euthanasia Consent Form

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