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Euthanasia Consent Form

We will provide a quiet and comfortable place and will make the process as peaceful and painless as possible.

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Euthanasia Consent Form

Name *

First

Last

Primary Phone *

Secondary Phone

Email *

Pet's Name (Patient) *

I, the undersigned, am the owner (or duly authorized agent for the owner) of the animal described above. I hereby consent to and order euthanasia (humane death) to be performed on this animal, forever releasing North Ranch Animal Hospital and its staff from any and all liability for performing said euthanasia. I also certify that the above animal has not bitten any person or animal in the last (15) days, and to the best of my knowledge has not been exposed to rabies.

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 and staff to take charge of my pet’s remains in accordance with hospital policy, releasing the hospital, veterinarians, and agents from any and all liability for performing said after-death care, with the following stipulations included:

Please indicate your decision for care of remains by initialing below:

Return remains for personal disposition
Communal cremation (Basic)
Individual cremation (remains will be returned to NRAH for pickup by owner unless otherwise specified)
Please hold remains pending our decision. If I have not informed NRAH of our decision within 10 days, I authorize communal cremation

Learning the cause of death of your pet can be of great help in relieving the suffering of other pets, as well as contributing to our understanding of health and disease. Unless you request otherwise, a postmortem evaluation may be performed on your pet prior to cremation. Should we choose to do this, you will not be charged unless you wish to receive a report.

I DO NOT authorize a postmortem evaluation.

Dated at __ hour, on this day of __, 2021.

Date

Time

Signature *

Clear Signature

Date *

Witness

Name

Euthanasia Consent Form

Euthanasia Consent Form

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