I, the undersigned, am the owner or duly authorized representative of the owner of the pet listed above. I hereby consent to and request humane euthanasia for my pet and release the veterinarian(s) and staff of Wilkes County Veterinary Services from any and all claims, except claims of negligence, arising from or connected with the life-ending procedure and the subsequent disposal of my pet’s remains. I understand that I am responsible for any costs associated with euthanasia, including but not limited to, any previous balance of pet, any sedatives administered, the euthanasia procedure, and/or the cremation option selected.
I have been informed of all of my options for my pet’s remains and hereby authorize the attending veterinarian to dispose of my pet’s remains via the option I have selected below:
