Euthanasia Consent

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Euthanasia Consent

Name *

Date *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone *

Email *

Pet's Name *

Species *

Breed *

Color *

Age *

I, the undersigned, certify that I am the owner (or an authorized agent for the owner) of the above request, consent to, and order euthanasia to be performed on the said animal. To the best of my knowledge, and belief, this animal has not bitten any person or animals during the past fifteen days and has not been exposed to rabies. I give the doctor (his/her), (agents, and representatives) full and complete authority to euthanize and dispose of the said animal in a humane manner and in accordance with the rules and regulations of the establishment. Furthermore, I forever release the doctor or representatives from any and all liability of the said euthanasia. *

I have read and understand.

Signature of Owner

Clear Signature

Signature of Witness:

Clear Signature

PLEASE INDICATE YOUR DECISION FOR CARE OF REMAINS BY INITIALING BELOW: *

Take the body home immediately after euthanasia
Ceremonious or Group cremation (ashes will not be returned)
Private cremation (remains will be returned to HPVS for pickup by owner unless otherwise specified)

We proudly serve the pets of Wolf Point and beyond.

Our philosophy is to provide excellent customer service and first rate pet care. We strive to create a relaxing-friendly environment for you and your pet. Our clinic is comfortable, pet-friendly, and calm.

Euthanasia Consent

Euthanasia Consent

We proudly serve the pets of Wolf Point and beyond.

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