Euthanasia Inquiry

1
Name* This field is required.
First Name
Last Name
2
Email* This field is required.
example@example.com
3
Phone Number* This field is required.
4
Would you prefer to be contacted by e-mail or phone?* This field is required.
Email
Phone
5
Address* This field is required.In order to provide you with an quote for our services, we need your physical address. We do not share this information with anyone. If you would prefer to call us we can be contacted at 503-281-1631.
Street Address
Street Address Line 2
City
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State
Zip Code
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Country
6
Your Cat's Name
7
Is your pet a cat or a dog?* This field is required.
Cat
Dog
8
Is your cat male or female?
Male
Female
9
What breed is your catt?If you do not know, please just type UNK.
10
How old is your cat?An approximate age is fine, if you don't know for sure.
You only need to enter the number and not "years" or "yrs," etc.
11
How much does your cat weigh?Please provide weight in pounds. If you aren't sure, please give an approximate weight. This assists us in knowing what supplies to bring, if we come, as well as to provide aftercare options for you.
You only need to type in a number and not "lbs" or "pounds"
12
Please tell us why you feel it is time to say goodbye to your cat.If you aren't sure, please ask about an optional quality of life assessment. We do not euthanize healthy pets or pets with treatable medical conditions who still have a reasonable quality of life. Healthy, aggressive/dangerous pets must have a referral from a local veterinary behaviorist that euthanasia is a last resort to protect the safety of people or other pets in the household.
Huge
Large
Normal
Small
Ok
Ok
13
Were you referred to us by a friend or another veterinary service?* This field is required.
YESNO
14
Please enter the name of the person or service that referred you.We would like to be able to send that person or service a "thank you" note.
15
Would you please let us know how you found us?* This field is required.
Google Search
Bing Search
Yelp
Other Internet Search
Other
16
Please click "SUBMIT" to complete this form* This field is required.Depending on your device/browser, you may be challenged to confirm you are human, if not, you can just click submit.
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