Euthanasia Authorization Form

Pet's Name

Age (years)

Sex

Breed

German Shepard, Chihuahua, Boxer, etc..

Owner's Name

First NameLast Name

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number

Please enter a valid phone number.

What is Cremation?

Just like with human cremation, flame-based pet cremation uses high heat to reduce a body to cremated remains, or what most people call "ashes".

Communal Cremation

Pets are placed in the crematory together and cremated together. With a communal cremation, cremated remains are not returned to the family.

Communal Cremation 3lbs or less (exotic) $40.00

Communal Cremation 30 lbs or less $86.00

Communal Cremation 30 lbs - 60 lbs $98.00

Communal Cremation 60 lbs - 90 lbs $134.00

Communal Cremation 90 lbs and over $152.00

Individual Cremation

More than one pet may be placed in the crematory with a physical separation from other pets. Location is documented and remains are removed one at a time and kept separate. The cremated remains (ashes) of a pet, and only that pet, are returned to the family.

Individual Cremation 3lbs or less $196.00

Individual Cremation 30 lbs or less $256.00

Individual Cremation 30 lbs - 60 lbs $276.00

Individual Cremation 60 lbs - 90 lbs $304.00

Individual Cremation 90lbs or more $376.00

After euthanasia, would you like to take your pet back home or do you want your pet to be cremated?

Would prefer Communal Cremation (will not get your pets ashes returned) or Individual Cremation (you will get your pets ashes returned, in an urn).

Would you like any of your pets belongings returned to you? If so, please give a description of their belongings so we make sure to keep them.

Would you like us to make a clay pawprint for you?

Would you like the paw print to be Heart shaped or Round?

Please confirm the spelling of your pet's name.

Pet's name

I, the undersigned, do hereby certify that I am the owner (duly authorized agent for the owner) of the animal described above; that I do hereby give Bosque Animal Clinic complete authority to humanely euthanize said animal. I release Bosque Animal Clinic from any liability for euthanizing this animal.

I do also certify that the said animal has not bitten any person or animal durng the last fifteen (15) days, and to the best of my knowledge has not been exposed to Rabies.

Date

Signature