After Care Form

Owner's Name*

First NameLast Name

Contact Number*

Area CodePhone Number

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Pet's Name*

First NameLast Name

Breed*

Sex*

Age*

Color*

Markings

Has your pet bitten anyone within the last 10 days?*

YesNO

Humane euthanasia?*

This service is $79.28

Pet Burial*

At Home Burial- allows you to bring your pet back home with you. At no additional cost to humane euthanasia, we will provide you with a burial casket to bring your pet home.Communal Cremation- Allows your pet to be respectfully and compassionately cremated. When you choose communal cremation, you will not receive your pet’s ashes back. 0-30lbs: $87.52, 31-60lbs: $98.54, 61-90lbs: $136.89, 91-200lbs $162.81Private Cremation- provides you with the opportunity to keep your pet’s cremated remains as a permanent and personal keepsake. When you choose private cremation, your pet will be the only pet in the cremation chamber during the cremation process. When the cremation process is complete, Louisiana Pet Crematory ensures that you receive only the cremated remains of your pet. . 0-30lbs: $260.60; 31-60lbs: $290.40; 61-90lbs: $330.52; 91-200lbs: $349.21

Would you like a clay paw print of your pet made? *

This service is an additional $25

Special Requests

We understand this can be a difficult decision, if you cannot decide on your pet’s aftercare handling at this time, we can hold your pet’s body for 10 days until a decision can be made. If a decision cannot be reached within 10 days, communal cremation will be performed.

If you do not pick up your pet's ashes within 30 days, we will assume you are physically or emotionally unable to do so, and we will spread them in an appropriate place and manner.

Would you like LVCC to hold your pet until a decision is made?

YesNo

I, the undersigned, do hereby certify that I am the owner (duly authorized agent for the owner) of the animal described above; that I do hereby give Lafayette Veterinary Care Center, its agents, servants, and representatives full and complete authority to euthanize the said animal in whatever manner the attending doctor, his agents, servants, or representatives shall deem fit.

I do hereby and by these presents forever release LVCC, its agents, servants, or representatives from any and all liability for so euthanizing the said animal.

I do also certify that the said animal has not bitten any person or animal during the last fifteen (15) days, and to the best of my knowledge has not been exposed to rabies.

Lastly, I agree that all information contained on this form is accurate and if applicable, grant my permission to Louisiana Pet Crematory to perform the cremation procedures requested above.

Signature

Please visit www.lapetcrematory.com to view a catalogue of urn upgrade options as well as their extensive collection of memorial keepsakes.

Euthanasia & After Care Form