Owner's Name
*
First Name
Last Name
Owner's Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Owner's Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Pet Information
Pet's Name
*
Type of Pet
*
Dog, Cat, Bird, Etc....
Breed
Male
Female
Agreement
Vernal Pet Cremation is open 9:00AM-5:00PM Monday-Friday, Closed Federal and State Holidays. No pickups, drop offs, or receiving of urns will be allowed outside our office hours. We apologize for any inconvenience this may cause
*
I Agree
Once, you have filled out this form, you are welcome to drop your pet off anytime during normal hours as seen above, no appointment is necessary. Drop off will be at the crematorium behind the funeral home at "Door C", once you arrive, give us a call at 435-789-2834 and we will meet you at the door.
*
I Acknowledge
CREMATION PROCESS: The undersigned acknowledges that due to the nature of the cremation process, any material on the remains of the Pet, such as collars, tags, blankets, etc, will be destroyed if not removed by the owner. Accordingly, the undersigned understands it will either be destroyed or removed and disposed of by the Crematory.
*
I Agree
CREMATION AUTHORIZATION: The Owner or Legal Representative hereby authorizes the Crematory to arrange the cremation of the remains of the Pet at their facility. In providing this authorization, the undersigned represents that he or she is the Owner or the Legal Representative of the Owner and has the full right and authority to arrange the cremation and disposition of the cremated remains.
*
I Agree
I understand the urn will be available for pickup by the next business day between 9am-5:00pm, excluding weekends and all federal and state holidays.
*
I Agree
I understand if urn is not picked up from Vernal Pet Cremation within 30 days of pet drop off the crematory has the right to dispose of ashes in a legal manner.
*
I Agree
Options
If you selected and paid to have your pet picked up by Vernal Pet Cremation, please provided address below. We will contact you or the vet clinic to schedule a time for pickup.
Name of Vet Clinic where pet is located:
IF APPLICABLE
Phone Number of Vet
IF APPLICABLE
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
I give my permission for Vernal Pet Cremation to cremate my pet. I provided truthful responses above.
*
Clear
My Products
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Pet Cremation
Please select weight below. If you don't know your pets weight, please select one that is closest. A credit or charge will take place once we weigh your pet.
$
60.00
Weight
0-5lbs
6-20lbs
21-40lbs
41-80lbs
81-110lbs
111-130lbs
131-150lbs
151-250lbs
251-400lbs
Pet Transportation
Please select one of the following
$
Free
Drop off or Delivery
Family will bring pet to Vernal Pet Cremation
Vernal Pet Cremation will pick up pet from vet or other location within 30 miles
Paw Print
$
25.00
Quantity
1
2
3
4
5
6
7
8
9
10
Fur Clipping
$
5.00
Quantity
1
2
3
4
5
6
7
8
9
10
Plastic Bag
$
Free
Wood Urn with Brass Paw Prints
$
55.00
Rainbow Bridge
$
70.00
All Dog Go To Heaven
$
85.00
Tree of Life Urn
$
55.00
Paws To Heaven
$
99.00
Journey
$
99.00
Dog Angel
$
85.00
Three Band Pewter
$
99.00
Tin Paw Prints
$
30.00
Utility Urn
$
15.00
Keepsake Necklace (Pill Shaped)
Holds Ashes
$
35.00
Color
Quantity
Purple
1
2
3
4
5
6
7
8
9
10
Yellow
1
2
3
4
5
6
7
8
9
10
Pink
1
2
3
4
5
6
7
8
9
10
Black
1
2
3
4
5
6
7
8
9
10
Blue
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Love Paw Print)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Butterfly)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Cross)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Fish Hook)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Feather)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Heart)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Snow Flake)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Circle with Paw Print)
Holds Ashes
$
35.00
Keepsake Necklace (Infinity)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Dog Tag)
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Color
Silver
Black
Key Chain (Rainbow Bridge)
Does not hold ashes.
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Paw Print Cylinder)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keychain (Paw Print Charm)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Key Chain (Angel Wing Cylinder)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace "Heart Color Flowers)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklaces (My Best Friend)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Keepsake Necklace (Butterfly Flowers)
Holds Ashes
$
35.00
Quantity
1
2
3
4
5
6
7
8
9
10
Mail Urn Back to Family
If family wants us to mail the urn back to them instead of picking up urn at the crematorium.
$
65.00
Quantity
1
2
3
4
5
6
7
8
9
10
Product Name
$
Free
Quantity
1
2
3
4
5
6
7
8
9
10
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Submit
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