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Euthanasia Consent Form
Pet Name
*
Breed:
*
Sex:
*
Sex:
A
Male
B
Female
Age:
*
Color/Markings:
*
I, the undersigned owner, do hereby certify that I am the owner or duly authorized agent for the owner of the pet described above.
I give Austin Urban Vet Center the complete authority to euthanize the above described pet. To the best of my knowledge and belief, this pet has not bitten any person during the previous 30 days and has not been exposed to Rabies.
Please select one of the following options:
*
Please select one of the following options:
Take pet home for burial: $56
Communal Cremation (Ashes spread in communal pet garden): $188.50
Private Cremation with ashes returned to you: $436 (this
Would you like to receive any of the following complementary items? Available with Communal or Private option, and at no extra charge.
Clay Paw Print
*
Clay Paw Print
A
Yes
B
No
Ink Nose Print
*
Ink Nose Print
A
Yes
B
No
Ink Paw Print
*
Ink Paw Print
A
Yes
B
No
Please verify the information below:
*
*
*
*
Signature:
*
Signature
Submit
