Preferred date/time of services (Sometimes pets take a turn for the worse overnight or in a short amount of time, so we do our best to accommodate same day appointments with a few hours notice, but cannot guarantee that).
*
Today
Tomorrow
Morning
Afternoon
Evening
Next 3-7 days
Next 7-14 days
Next 14-28 days
In the near future, but my pet is currently doing very well. Likely weeks-months from today.
If you have a specific date and time preference, please list it below
Reason for euthanasia
*
Cancer
Poor quality of life
Organ failure
Other
Location of euthanasia
Home (Address below)
Beach of choice
Owner Full Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address (Physical)
*
Street Address
Street Address Line 2 (Include Gate Code if needed)
City
State / Province
Postal / Zip Code
Address (Mailing - ONLY if different from above). This information is used to send sympathy cards.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Species
*
Please Select
Canine (dog)
Feline (cat)
Avian (bird)
Other
Breed
Pet's Name
*
Estimated Pets Weight (#/Lbs)
*
* If your estimated weight is much different from your pets actual weight, your cremation charge may change.
Color
Age in years
*
Sex
*
Male
Female
Is your pet fearful of medical staff or clinical gear (e.g. scrubs, stethoscope)?
No
Yes (Vet will arrive in plain clothes and keep medical equipment tucked out of sight).
Does your pet experience severe anxiety, fear of needles, or struggle with stranger reactivity/aggression during medical visits? (Pre-visit oral sedatives are available to help keep them calm and relaxed prior to our arrival).
No - My pet does not need pre-visit sedation.
Yes - Please call in an Rx to a pharmacy near me.
Yes - I'll call my primary veterinarian to obtain pre-visit medication.
Other
Family Veterinary Hospital (You can list multiples if needed)
Would you like Maui Sunset Veterinary Care to notify your family veterinary clinic of your pets passing?
Yes
No
Optional Keepsakes (Complimentary)
*
Clay paw print
Ink paw print
Ink nose print
Glass vial with fur clipping
All of the above
No thank you to all of these options
Please choose one of the following payment methods
*
Cash (Preferred)
Check (Preferred). Please make check out to "Maui Sunset Vet Care"
Zelle (Preferred) account: 808-758-1449 (a QR code can be texted to you)
Credit Card (An invoice will be emailed with a link to pay the day of service). To help us maintain our mobile veterinary services and keep our base rates stable, a 3% Credit Card Surcharge (plus applicable GET) is applied to all credit card transactions. This fee covers a portion of our processing costs and does not exceed the amount we pay to our processor.Note: This fee is waived for payments made via Debit Card, Check, or Cash.
Credit Card, I would like to pay at time of service (in person). To help us maintain our mobile veterinary services and keep our base rates stable, a 3% Credit Card Surcharge (plus applicable GET) is applied to all credit card transactions. This fee covers a portion of our processing costs and does not exceed the amount we pay to our processor.Note: This fee is waived for payments made via Debit Card, Check, or Cash.
Venmo Business Account @MauiSunsetVet
CareCredit https://www.carecredit.com/go/756RSN/ CareCredit is a healthcare credit card designed specifically to help pay for out-of-pocket medical expenses, including veterinary care. It works like a traditional credit card, but it can only be used at participating healthcare and veterinary providers.
Where may the doctor park?
Driveway
Street
Visitor parking stall
Other
How do you want the veterinarian to notify you when they arrive?
Knock on door
Ring doorbell
Text me
Call me
Other
Email
*
example@example.com
Aftercare. Transportation to the crematory is included in the cremation charges (your pet will be transported to the crematory after euthanasia). Ashes will be picked up by owner at the respective crematory of your choice.
*
Home Burial
Private Cremation at Maui Humane Society (Benefit of being a local non profit, however, Estimated time for return of ashes varies on your choice either under 72 hours or 3-4 weeks.
Private Cremation at Paws Forever [Makawao Veterinary Clinic] (Estimated return of ashes is 7 days). More expensive than Maui Humane Society.
Group cremation (no ashes returned) at Maui Humane Society (Benefit of being a local non profit)
Self-Transport Cremation. This option requires you to handle all aspects of the cremation process, including transportation and payment. You will be responsible for transporting your beloved pet to the crematory of your choice and making direct payment to the crematory for their services.
Private Cremation at Paws Forever [Makawao Veterinary Clinic] (48 hour return: $1000). More expensive than Maui Humane Society, More expensive then 7 day Paws Forever.
By signing below, I authorize Maui Sunset Veterinary Care to gently and humanely euthanize my pet and facilitate our chosen aftercare. I confirm that I have the legal authority to make this decision.
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