Owner Name *

First

Last

Address *

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Address Line 2

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State

Zip Code

Phone Number *

Email *

Pet Name *

Species *

Canine
Feline
Other

Please specify. *

Sex *

Male
Neutered Male
Female
Spayed Female

Color *

Age *

I, the undersigned, hereby state that I am the (legal owner / legally authorized representative of the legal owner) of the pet listed above. I am authorized to make any and all medical decisions regarding this pet. I have declined any further care for the pet listed above and am hereby authorizing All Vet Care Hospital to euthanize the pet listed above.

I agree to have All Vet Care Animal Hospital choose a euthanasia protocol at their sole and exclusive discretion. I have had all my questions and concerns regarding this process answered prior to signing this consent. I attest that the above-listed pet has not been exposed to rabies, has not bitten anyone, and has not displayed any signs of unusual attitude or aggression in the last 15 days.

It is my desire to provide decent and humane after-death care for my pet, complying with all legal requirements of the surrounding area. I authorize All Vet Care Animal Hospital to take charge of my pet’s remains in accordance with hospital policy, releasing the staff from any and all liability for performing said after-death care.

I request that this animal’s remains be cared for in the following marked manner: *

Private Cremation with return of ashes. I wish to have my pet individually cremated.
Cremation with no return of ashes. My pet’s remains will not be returned to me.
Home Burial. I wish to take my pet’s body home.

I would like to request a paw print to be returned to me. *

Yes
No

Client Signature *

Clear Signature

Today's Date *

Euthanasia Consent Form

Euthanasia Consent Form

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