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Euthanasia Final Arrangement Consent Form

I, hereby request and authorize euthanasia for. I am fully authorized to consent to and grant approval for this procedure.

Has this animal bitten any person or animal within the previous ten (10) days?

Special Final Care Instructions

Options include: *PLEASE SELECT ONE*

I would like clay paw prints*.

*Clay paw print available only with private cremations for an additional charge.

All ashes/clay paw prints will be mailed. Please initial to confirm address

*If you should need time to make a decision on your pet's final arrangements, Tufts VETS can hold your pet for 48 hours. There will be a fee of $25.00 which will be reversed upon final arrangements being confirmed. If we do not hear from you, we will make every attempt to contact you. However, if we cannot reach you your pet will be released for a group cremation (with Final Gift Pet Cemetery) and you will be invoiced for the service.

Signature of Owner Agent

Date

Contact Information

Client Name

Patient Name

Address

City

State

Zip

Phone

Email

Questions or Comments