Request Appointment - Vet 2 The Starz

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState

Zip Code

Phone Number

Please enter a valid phone number.

Email*

*An Additional travel fee may apply based on our service map.

Preferred Method of Contact

TextPhone CallEmail

Any other request or information to add for at-home euthanasia? Gate codes, directions, etc.

What day and time would you prefer us to come to your home? All regular appointment times are during business hours: Monday-Friday 10am-6pm, and Saturdays from 10am-3pm. Appointments outside of these hours have limited availability. Appointments last up to 2 hours.*

MorningAfternoonEveningLate Evening (7pm-9:30pm) (Additional fee may apply.)

Your Pet's Name*

Brief information about the issue(s) your pet is having:*

Species*

CatDogOther

Pet's Gender*

MaleFemale

Pet's Age

Your Pet's Estimated Weight (in Pounds) for Dosing Medications *Important**

What are you wishes for aftercare and/or keepsakes?*

Private Cremation (Includes standard urn options, paw print, certificate of authenticity, and hand delivery of all keepsakes. Additional keepsakes available for order.)Communal Cremation (No ashes returned.)Communal Cremation (Additional keepsakes available for direct customer order.)Home Burial (Please check all local and county regulations.)Other

Would you like us to notify your primary care veterinarian?

YesNo

If yes, who is your primary care veterinarian?