HeavenLee Companion Aquamation Authorization

Please contact us at 256-887-6008 if we can help with questions.

This authorization form is required to be completed and signed prior to the final disposition of your pet. Aquamation is an irreversible and final process. It is important that you understand the aquamation process and different options available prior to signing it. The scientific name for this process is alkaline hydrolysis. It is the same process that occurs as part of nature's course when a body is laid to rest in the soil. We use a combination of gentle waterflow, temperature, and alkalinity to accelerate the breakdown of organic material. This process takes total 20 hours to complete. At the end of the process, the inorganic materials of the bone remain. This is pure calcium phosphate. The mineral remains are carefully dried and processed into a powder for return to the family. This processing step is identical to that which is performed with flame cremation. Once you've received your loved one's ashes, there are many ways to continue your journey. Anything you can do with cremation ashes, you can also do with aquamation ashes. We have a Private aquamation service where your pet is placed in a private cradle with an identifying metal tag to ensure that all of your pet's remains returned to you. Ashes will be returned to you in an urn of your choice with a certificate of aquamation. If you do not wish to receive your pets ashes, we provide Communal aquamation services. Your pet will be placed in a shared receptacle for aquamation and their ashes will be spread on our farmland. Your pet will be treated with the same gentle care we would give our own. We want you to fully understand the information provided in this authorization form, so we will be pleased to answer any questions you may have.

Owner’s Name*

First NameLast Name

Appointment Date/Time Scheduled with Companion Crossing*

Date

Hour MinutesAM/PM Option

Pet’s Name*

Type of Pet*

Cat, Dog, Other

Pet’s Approximate Weight*

Phone Number*

Please enter a valid phone number.

Email

example@example.com

We understand conversations may be difficult at this time. How would you prefer we contact you?*

Text messagePhone callEmail

Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Are there stairs in the pathway where your pet will be transported from your home to our vehicle?

NoLess than 3More than 5

For pets over 40lb, we ask that 1 helper be present to assist our representative in moving your loved one to our vehicle. For pets 90lbs and over, we ask that 2 helpers be available. Please let us know if you are unable or uncomfortable moving your pet so we can schedule appropriate help to be available. Will helpers be available to assist with moving your pet to our vehicle for aftercare transport?

YesNo, Please provide additional assistance.

If we are providing private aquamation services, please provide a location for return of remains. We will contact you to arrange a time for delivery.*

HomeNot Applicable Veterinary Clinic(please provide name)

Please let us know if there is anything you would like us to know about your pet.

We will be in touch to help with urn selection for your loved one. The urns above are sample designs, but are able to work with you to create a personal design to memorialize your loved one. You are also welcome to provide your own urn.

We are pleased to include a collection of keepsakes(see above) at no charge with our Private aquamation services.

I would like to receive keepsakes at no additional charge with Private aquamation service (You may also purchase additional keepsake sets or add them to Communal aquamation service for $30)No, thank you

We also offer a custom fired glass keepsake to memorialize your companion's paw print($99)

Please Select Aquamation Service Options*

Private Aquamation Pets up to 39lbs

$230.00

Private Aquamation Pets 40-100lbs

$280.00

Private Aquamation Pets 101+lbs

$350.00

Communal Aquamation Pets 40lbs and OverAshes will not be returned.

$140.00

Communal Aquamation Pets 39lbs and underAshes will not be returned.

$40.00

Add on Keepsake Package

$30.00 Quantity

Custom Glass PawprintPlease allow 10-12 weeks for delivery

$99.00 Quantity

Total

$0.00

I understand that a service fee of $50 for AFTER_HOURS(5pm or later), WEEKEND(Saturday and Sunday), or HOLIDAY appointments MAY be applied to this invoice total.*

Yes

Please select your preferred payment method. We do not accept checks.*

Credit Card( An invoice link payable online will be texted or emailed to you before we receive your pet for service. If you prefer to pay by credit card over the phone, please call 256-887-6008.)Cash(Exact change please)Scratch Pay

I agree for HeavenLee Companion Aquamation to complete the aquamation process and payment will be made before the aquamation process begins unless other arrangements have been made. (All remains must returned within 90 days)*

Authorization Release for Aquamation

256-887-6008