Page 1 of 1

Euthanasia Consent

Pet Name:

*

Client Name:

*

I give my consent to Wilkes County Veterinary Services to euthanize my animal. I understand there is a cost for euthanasia.

For my animal's remains, I elect:

*

For my animal's remains, I elect:

A

Individual cremation with ashes returned ($90+ based on weight)

B

Communal Cremation with no ashes returned ($25.00)

C

Take the remains with me

Owner Signature:

*

Signature

Date:

*