Euthanasia Consent Form - Established Patient

Answers to the following questions are important to ensure a smooth process during a difficult time or situation.
  • This question must be answered due to State Regulations for possible rabies exposure.
  • Due to current State regulations, this request to be present may not be possible to fulfill. Please confirm at the time of the appointment.
  • Cremation is provided at additional cost by third party. "No Return" is approximately 42.00 for any size where "Return" is 90.00 to 400.00 depending on size and choice of standard or custom urn.
  • Third party removal service is available at approximately 225.00 to 295.00 where burial is privately contracted.
  • We empathize with you on these difficult times and decisions. We will strive to make the situation as comfortable and compassionate as possible. Please share with us any special requests you may have.
  • Date Format: MM slash DD slash YYYY
  • Sign with finger if mobile phone or tablet, drag mouse if PC or Mac.
  • This field is for validation purposes and should be left unchanged.