Euthanasia Consent Form

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Euthanasia Consent Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet before your visit.

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Name

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Last

Address

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City

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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

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Date

Name

Euthanasia Consent Form

Euthanasia Consent Form

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