Euthanasia Consent Form

Save time during your next appointment. Complete your euthanasia consent form online from any device before your visit.

Euthanasia Consent Form

Please fill out this form as completely and accurately as possible so we can get to
know you and your pets before your visit.

OR

You may use the PDF version by clicking the DOWNLOAD FORM button and then completing the printed form by hand. Please bring the completed PDF form with you for your pet’s first appointment.

DOWNLOAD FORM

As owner, or duly authorized agent of the owner, of the animal described hereon, I hereby consent to, and order, euthanasia to be performed on same for humane reasons. I further authorize the attending veterinarian to dispose of the remains in accordance with hospital policy. I realize that I will be financially responsible for any and all charges incurred in connection with said euthanasia services.

To the best of my knowledge and belief this animal has not bitten any person during the ten days preceding this date.

Owner’s Name:

Pet’s Name:

Email

Species:

Canine
Feline
Other

Breed:

Sex:

M
MN
F
FS

Age:

Weight:

I would like for GULFSHORE ANIMAL HOSPITAL to care for my pet. I understand that my pet will be placed in a body receptacle, identified with my instructions as listed below, and kept under refrigeration until picked up by a pet burial service authorized by Gulfshore Animal Hospital. My instructions are as follows:

Please Initial Choice:

Private Cremation

(Ashes Returned)

Communal Cremation

(Group cremation – no ashes returned)

Special Instructions:

Owner’s Signature *

Clear Signature

Date *

Comment

Euthanasia Consent Form

Euthanasia Consent Form

Location

Call Us

Email

Hours