Angel Oaks Euthanasia Appointment Information & Consent Form

For questions or more information, click to call +1(713)946-6223

21755 Interstate 45 N, Building 11, Spring, TX 77388

Click address above for Google Maps Link

Customer Type

CUSTOMER INFORMATION

Owner/Agent's Name*

First NameLast Name

Customer Phone #*

Please enter a valid phone number.

Customer Email*

example@example.com

Zapier Phone Number

Please enter a valid phone number.

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

PET INFORMATION

Pet Name*

Pet Weight (lbs)*

Pet Age*

Pet Sex*

FemaleMale

Species*

If "Other", please indicate species type

Breed*

Temperament*

Agressive Behaviour Additional Cost

Is your pet mobile?*

APPOINTMENT INFORMATION

Appointment Type*

Appointment Cost

If you requested an in-home appointment, please note the euthanasia will be performed inside your home.

Reason for Euthanasia Service Requests*

ALL APPOINTMENT TIMES MUST BE CONFIRMED WITH AN ANGEL OAKS FAMILY MEMBER

Appointment Date & Time*

# of Family Members Attending Service?

Estimates are ok. This number helps us with making your appointment as comfortable as possible.

SERVICE OPTIONS

Cremation Type*

Cremation Cost

Private creamations are typically completed within 24 hours and available the next day. If not, an Angel Oaks family member will call you when your beloved pet is ready to return home. For In-Home euthanasia appointments, please allow for 48 hours from your appointment for delivery of your beloved pet home.

Viewing services are an additional $200 and require additional scheduling, and therefore must be confirmed by an Angel Oaks team member. After hours & weekend viewings (6:00PM-8:00AM) may include additional fees.

Complimentary Clay Paw Print?

YesNo

Extra Clay Paw Prints

Clay Paw Print(s) - Qty

Clay Paw Print Cost

Ink Paw Print(s) - Qty*

Ink Paw Print Costs

Ink Nose Print(s) - Qty*

Ink Nose Print Cost

Hair Clipping(s) - Qty*

Hair Clipping Cost

Urn Type*

*Please speak with an Angel Oaks team member if you are interested in purchasing an upgraded urn. Upgraded Urn prices vary dependent upon the model.

Follow this link to see our upgraded urn options

Nameplate*

Base Option - Pet's Name Only (Complimentary)Specialty Engraving - Engrave up to 4 Lines (Additional $15)

Nameplate Cost

Engraving Line #1

Engraving Line #2

Engraving Line #3

Engraving Line #4

*Additional Information and/or special requests for the Angel Oaks Team

Total ($)

*additional costs may be added for after hours & weekend viewings

All attempts will be made to accomodate appointment times and special requests for, but these are requests and not final until confirmed with Angel Oaks Veterinary Services.

CONSENT FOR EUTHANASIA

Our doctor's time is very valuable, as is yours.

Payment of invoices are required to hold appointment times. An appointment is not set until the appointment form is completed and submitted and the invoice amount is paid in full

If any changes are needed to be made to your appointment time, please notify Angel Oaks no later than 24 hours before your scheduled appointment.. The full invoiced amount will be rrefunded if the appointment is canceled with 24 hours notice or greater.

No shows or cancellations/reschedules less than 24 hours before the appointment time will forfeit the invoiced amount. Forfeiture of teh invoiced amount does not apply if your pet passes away within the 24 hour forfeiture period. The invoiced amount may be applied to our cremation service (and the difference refunded) if you decide to continue usin gour cremation service for your pet.

To the best of my knowledge, my pet has not bitten, scratched, or otherwise potentially exposed any person or other animal to rabies in the past ten (10) days. I understand that if the animal described above has bitten or otherwise potentially exposed any person within the time specified, a rabies test must be performed*

I Agree

I certify that i am the legal owner/duly authorized agent for the owner of the animal described above and do hereby give Angel Oaks Veterinary Services and any authorized agents, staff or representatives full and complete authority to euthanize and cremate said animal in a humane and dignified manner. I hereby forever release and hold harmless Angel Oaks Veterinary Services and any authorized agents, staff, or representatives from all liability for euthanasia and cremation of said animal.*

I Agree

I understand that euthanasia is the act of ending the life of an animal in a painless way to prevent any unnecessary suffering. To the best of my knowledge, the information I have provided is accurate and complete. I understand that my wishes may be carried out immediately upon my signing of this agreement. Fees for these services have been explained to me, and I assume full responsibility for all charges applicable to such services. I have carefully read and fully understand the foregoing provisions.*

I Agree

Owner/Agent's Signature*

Clear

Date Signed*

Upgraded Urns & Memorial Products

If you are interested in an upgraded urn, please follow the link above to our Memorial Products web page

Euthanasia Information & Consent Form

For questions or more information, click to call +1(713)946-6223

21755 Interstate 45 N, Building 11, Spring, TX 77388