First and Last Name

At-Home Euthanasia Appointment

with Dr Patrick Africano Ark Angel Vet
Thank you for your enquiry regarding a peaceful pet euthanasia in the comfort of your home with Dr Patrick from Ark Angel Vet.

I aim to bring your pet Respect, Compassion, Dignity and Peace during your at-home appointment. Also, to create a meaningful experience that honours your beloved pet.

If you have any questions regarding my approach during this very difficult time, please contact me directly on 0408 915 550.

You may find it helpful to view some of my Clients' Reviews on Google via this link:

Google Reviews Link Ark Angel Vet
https://g.co/kgs/iPZnN1

My Ark Angel Vet Website:

https://arkangelvet.com.au
Your Details
Name*

PrefixFirst NameLast Name
Mobile Number *
Email Address*
Address*
Please include any details on the best place to park etc.
People attending the appointment & other family members. For Children their First names and their ages. *
So that I can include them in my condolence card.
Your Pet’s Details
Your Pet’s Name & Sex*
Your Pet is a:*

DogCatOther
Your Pet’s Details: Breed & Colour*
Your Pet’s Age*
Your Pet's Gender*

MaleFemale
Pet’s Body Weight*
In Kgs
Pet’s Diagnosis *
Age related illness, Cancer, Heart Disease, Kidney Disease, Arthritis, Loss of mobility, Paralysis, Dementia, Diabetes, Hyperthyroidism, Spinal Disease, Unknown diagnosis or Other - specify.
Your Pet's Behaviour*

Very friendly.May be anxious - with strangers.May be Reactive or Aggressive and a potential bite risk. May need pre visit Meds, or extra Sedative doses, that will incur an extra fee.Behavioural Euthanasia for Aggression - Will need pre visit Meds, and extra Sedative doses, Total fee is $650.
Your Pet’s Regular Veterinary Surgeon is*
Your Pet’s Regular Veterinary Hospital *
You can add any recent Specialty Centre or Emergency Hospitals visits.
Regular Veterinary Hospital phone number *
I will call them to inform them of your pet’s passing.
Choose Your Appointment Type

If you are not sure please text or call Dr Patrick on 0408 915 550.
Select your visit:*

Premium One Hour Visit - Normal Hours & < 40 Km from Perth CBD - $495Exotic Pet Visit - Rabbit, Rat, Bird or Guinea Pig -$495Emergency Appointment - $595 * Appointment within 2 hours of first contact. (Travel fees may apply if your pet passes while I on my way. From $0 to $250.Out of Hours Visit -$650Out of Service Zone $650 (40 to 50 km from Perth CBD)Out of Hours & Out of Service Zone $950Behavioural Euthanasia $650 (For aggression - Includes pre-sedation tabs)Special Location, Park, River or Beach ( up to a 2 hour visit) $650Two Pet Euthanasia's at the same Visit $650 - (normal fee is $495 x 2 - $990)The Essential Option (1/2 Hour) Plus $40 per 15 minutes of extra time if needed.
Please select your Preferred Appointment Day and Time

My Normal Hours of Service are - Mon to Sat 10 am to 4 pm. I will contact you re an appointment time as close as possible to your requested time
Appointment*
If you are not able to find your ideal time please fill in your day and time in this box .
Cremation Company Options

Please Choose from the Following Options
Cremation Companies*

Ripple Aquamation - Covering the whole Metro Area ( My Primary Recommendation) https://rippleaquamation.com.au. Is an Environmentally sustainable and economical option.Lawnswood Cremations - Eastern SuburbsPassing Paws Cremations - Northern SuburbsEvermore Pet Cremations - Southern SuburbsIf you wanting Cremation + Transfer without ashes returned the total fee is $295 (Plus my Euthanasia Fee)Murdoch University Education Donation - Transfer Only Fee is $195A Cremation Option without Ashes Returned , includes transfer by me. The Total Fixed fee is $295 (* In addition to the Euthanasia Fee)No Cremation Needed - We are opting for a Home Burial.Other
Post Appointment Transfer Options

To a Cremation Facility
* Yes I can transfer your Pet after our appointment.

* Please note: The costs of your pet's transfer after our appointment are in addition to the above Euthanasia fees and do not include cremation.

I offer three types of Transfers.

1. Premium Direct Transfer To Ripple Aquamation or another Cremation Facility is $195 immediately after the end of your appointment. *(Time of day permitting)

2. Standard Indirect Transfer: May be needed due to timing eg end of day or weekends. $120: Transfer of your pet to my home for collection later by the Cremation Company, as is standard for Veterinary Hospitals.

* The Aftercare Company does not charge any additional collection fees for transfers to their facility from my home collection.

3. Transfer to Murdoch University - $195, for Education Donation. NB. They may not be available at all times, or on Saturday or at short notice.
* If you have chosen your pet to be donated to Murdoch University Education

Please contact Stacey at Murdoch Uni to register your details before our visit so they are expecting my Direct Transfer of your pet after their At-Home Euthanasia.

Stacey 0424 178 178

* She will send you a form for completion via email.
Select you Pets Transfer
Transfer If Needed*

1. Premium Direct Transfer is $195 Only available during their opening hours2. Standard Indirect Transfer is $1203. Transfer to Murdoch Uni (Teaching Donation) $195No Transfer Needed - We will be doing a Home BurialOther
Payment Options

Pre-Payment is Preferred.
After your fee is confirmed, I would gently recommend pre-paying so that during our appointment, we can focus entirely on supporting you and your beloved pet through a peaceful and loving goodbye.

I will confirm your total fee when confirming your appointment time.

You can use PayID by entering my mobile number 0408 915 550. Once you’ve made the payment, please send me a quick text with your receipt. I will bring a printed receipt for you to our appointment.

Unfortunately I do not have the ability to extend credit or payment options at this time. Payment is preferred before or at the time of the visit.
Payment Preference*

Credit Card over phone (Fees apply)PayID use mobile # 0408915550Credit Card at the end of our visit (Fees apply)Debit Card at the end of your visit. A physical card is required (30 cents flat fee)Cash
Are you claiming the Euthanasia fees from Pet Insurance*

NoYes
Could you please let me know who connected us, so I can a pass on my gratitude.*

Google/WebsearchSocial Media - FacebookFamily or Friend & NameMy Regular VetEmergency VetDr Ann VetSpecialistI am already a ClientOther
Questions, Concerns, Special Requests - Or if you need clarification regarding any of the options.
Please let me know if you have any particular requests or concerns.
Please text me after signing and submitting this form.

* If this form is not submitting please check for a Red notice in the form above for a required field to be completed. I will then confirm your total fee and your appointment time. Dr Patrick Mb 0408915550
Euthanasia Consent *

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At-Home Euthanasia Appointment

Your Details

Your Pet’s Details

Choose Your Appointment Type

Please select your Preferred Appointment Day and Time

Cremation Company Options

Post Appointment Transfer Options

Select you Pets Transfer

Payment Options

Please text me after signing and submitting this form.