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Fill Out Our Euthanasia Consent Form
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Client Information
Name
*
First
Last
Email
*
Home Phone
*
Mobile Phone
*
Patient Information
Patient Name
*
DOB
*
Age
Breed
*
Age Phone Patient
Sex
*
Color
*
Consent
*
I am the owner or duly authorized agent of the owner for the above-named animal, I here by consent to and request humane euthanasia for my pet by a veterinarian at this practice
Aftercare Preference: What would you like us to do with your pet’s remains?
*
I wish the body to be returned to me / the owner
I request cremation and that the ashes be returned to me / the owner
I request cremation but do not want the ashes returned to me / the owner
I request a clay paw print
Signature
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Date
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