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Euthanasia Consent Form

Sugar Land Veterinary Clinic

Name

Cell Phone Number

Email Address

Pet's Name

Pet's Birthdate

Pet Sex

Pet Species

Pet Breed

How would you like us to care for your pet's remains?

I would like to receive my pets full remains to bury at home.

I would like the clinic to handle my pets remains with no ashes returned.

I would like to have my pet cremated and receive the remains.

Authorization

I, the undersigned, certify that I am the owner (or duly authorized agent for the owner) of the animal described above, that I do hereby give this hospital, its agents and representatives full and complete authority to euthanize said animal in a humane manner. I release the doctor and representatives from any and all liability for euthanasia of said animal. I certify to the best of my knowledge that said animal has not bitten any person or animal during the last ten (10) days, and has not to my knowledge been exposed to Rabies.