Euthanasia Consent Form

Name: Petvise Animal Hospital
Price range: $

Thank you for entrusting us with this deeply personal care. Please complete our online consent form to proceed. We are here to support you and your family in any way we can during this emotional time.

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Euthanasia Consent Form

Please fill out this form as completely and accurately as possible so we may proceed with your pet’s care. We are committed to ensuring your companion’s comfort and dignity during this process.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Pet's Name *

Species *

Breed *

Color: *

Age: *

I, the undersigned, am at least 18 years old, and I am the owner / duly authorized agent for the owner of the animal described herein. I hereby consent to and order euthanasia (humane death) to be performed on this animal forever releasing said doctor, hospital, and all agents from any and all liability for performing said euthanasia. It is my desire to provide for my pet decent and humane after-death care, complying with all legal requirements of the area. I authorize the attending veterinarian to now dispose of the remains in accordance with hospital policy, releasing the hospital, doctor and agents from any and all liability for performing after-death care, with the following stipulations included: *

I verify that the above stated pet has not bitten any person or animal during the last fourteen (14) days and to the best of my knowledge has not been exposed to rabies. *

I agree

Signature *

Clear Signature

Date *

Phone

Euthanasia Consent Form

Euthanasia Consent Form

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