In Home Euthanasia Appointment Request Form
Euthanasia for pets is a heart-wrenching choice. We hope to grant them a gentle passage, surrounded by the love they've known in the comfort of their home, sparing them further pain and ensuring their comfort until the very end.
Your Full Name
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First Name
Last Name
Address
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
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Secondary Phone Number
Please enter a valid phone number.
Email
*
example@example.com
Pets Name
*
Pet's Date of Birth
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Month
-
Day
Year
Date
Species
*
Please Select
Cat
Dog
What breed is your pet?
Approximate weight of your pet in pounds
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Who is your pet's veterinarian/ Which hospital do they go to for wellness services?
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Is your pet fearful, aggressive, and have they ever bitten anyone? Please explain. *Note: we cannot euthanize a pet that has bitten a person within the last 15 days
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All services are by appointment only. Which day(s) are preferable for you?
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Monday
Tuesday
Wednesday
Thursday
Friday
No Preference
Which after care option are you interested in?
Private Cremation: Includes certificate of cremation, premium sheesham urn, urn nameplate (pet's first name), and a clay paw print. Your pet's ashes will be mailed to you.
Communal Cremation: Your pet's ashes will be spread over a beautiful garden
I will keep my pet's remains
Unsure
I agree to the following:
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In order to keep everyone safe, if my pet is aggressive, I agree to a brief examination for oral sedative medications with CompassionVet or with my pet's primary care veterinarian prior to the humane euthanasia appointment. This will help to ensure safety and will decrease your pet's stress. If aggressive behavior causes our staff to feel unsafe, we reserve the right to reschedule, cancel, or discontinue an appointment at any time. If any other pet in the household is aggressive, they will be secured.
If I choose cremation for my pet over 20lbs, there will be at least one person available to help carry my pet to the car unless otherwise arranged with us. If my pet is over 50lbs, there will be at least 2 people to help carry my pet to the car (Dr. O'Brien has an injury and a lifting restriction of 20lbs)
My pet has not bitten anyone in the past 15 days
Would you like our veterinary staff to wear a mask during the appointment?
Please Select
Yes
No
This will be an in-home veterinary visit. Please have your pet ready at the designated appointment time. We will contact you when we are on our way with an estimated time of arrival. If you need to reschedule, please contact us at least 24 hours prior to your scheduled appointment time. All payments are due at time of service.
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