Bytown Cat Hospital: Consent to perform humane euthanasia

Consent to perform humane euthanasia

Bytown Cat Hospital, 422 McArthur Ave., Ottawa, ON K1K 1G6
Euthanasia is chosen to spare a pet from pain and suffering. Your cat will be sedated first to reduce anxiety and to place an intravenous catheter. Euthanasia is then performed by injecting an anesthetic drug through the catheter in an amount that will quickly cause unconsciousness and then gently stop the heartbeat. It is not painful for your cat.

It is important that you discuss the decision to euthanize your cat with the veterinarian and discuss treatment options (if any exist) so you are making an informed decision.

* Indicates an answer is required.

Please note all four sections below must be completed.
Your cat is a patient at which of our hospitals?

Bytown Cat Hospital, 422 McArthur Ave.Merivale Cat Hospital, 1038 Merivale Rd.
- Your name:*
  
  First NameLast Name
- Your address:*
  
  Street Address
  
  Street Address Line 2
  
  CityProvince
  
  Postal Code
- Your phone number:*
  
  Area CodePhone Number
- Your cat's name:*
- Your cat's age:*
- Your cat's colour:*
- Your cat's sex:*
  
  FemaleSpayed femaleMaleNeutered male
- I acknowledge that the veterinarian has discussed treatment options (if any exist) and I am giving informed consent for humane euthanasia.*
  
  YesNo
- I acknowledge that to the best of my knowledge, this cat has not bitten any person or animal within the past 10 days and has not been exposed to rabies.*
  
  YesNo
- I confirm that I am 18 years of age or older, I am the legal owner or an authorized representative of the cat described above, and I authorize the cat hospital to humanely euthanize this cat.*
  
  YesNo
- I acknowledge that I have read and understand this authorization. To the best of my knowledge, the information I have provided is true.*
  
  YesNo
- I request that my cat's remains be cared for by:*
  
  Cremation WITHOUT return of ashes to me (no additional cost)Cremation WITH return of ashes to me (there is an additional cost)I wish to take my cat's remains home with me (no cremation, no additional cost)
- Please select the type of urn you prefer (no additional cost). Your cat's remains are sealed inside the urn.*
  
  Blue metal urnTan metal urnCedar memorial urn (your cat's remains are in a soft silk pouch inside)Carved wood urn (your cat's remains are in a soft silk pouch inside)Blue scattering tube urn with pawprintsNone of the above
- To see other urn options (additional charges apply), please visit:
  
  https://www.gatewaypetmemorial.com/memorial-products-ontario/
- Personalization options are available for urns - please inquire for the cost. *
  
  Engraving of your cat's name (only on metal urns)An etched gold heart with ribbonEngraving on a cedar boxI do not want personalization
- Would you like a memento (no additional cost)?*
  
  Paw prints on a card (please contact us if you would like more than one card)A fur clipping on a card onlyPaw prints on a card with a fur clipping (please contact us if you would like more than one card)I do not wish to have a memento
- To see other memorial options such as clay pawprints (additional charges apply), please visit:
  
  https://www.gatewaypetmemorial.com/memorial-products-ontario/
- Date*
  
  MonthDayYear
  Date
- Signature
- If you wish, please enter your email address to receive a copy of this form:
  example@example.com
- Please verify that you are human*
- Please download this information on preparing for the euthanasia appointment.
- Should be Empty: