Euthanasia Consent Form

Owner Information

Owner's Name(Required)
Address(Required)

Pet Information

Euthanasia Appointment Policy

Our Veterinarian only performs euthanasia for humane reasons. A physical exam is performed at the beginning of every call. If our Veterinarian deems a euthanasia is unnecessary and is being requested for convenience and/or non-humane purposes, she reserves the right to refuse performing the service(Required)
If at the time of examination it is discovered a euthanasia cannot be performed due to the above listed reason, the client will still accrue the charges for a medical/illness examination and travel fee. Any payment received for cremation services will be refunded by Final Gift.(Required)
I the undersigned, do hereby certify I am the owner or duly authorized agent for the owner of the animal described above, I do hereby give the doctor of Paws by the Peaks Veterinary Health Services, PLLC permission to euthanize and dispose of said animal in whatever humane manner the doctor of Paws by the Peaks Veterinary Health Services, PLLC their agents, servants or representatives deem appropriate. I also release the doctor, Paws by the Peaks Veterinary Health Services, PLLC, their agents, servants, and representatives from any and all liability for euthanizing and disposing of said animal and understand the process of euthanizing my pet results in the cessation of life. I do also certify to the best of my knowledge the said animal has not bitten any person or animal during the last fifteen (15) days and has not been exposed to rabies. I have elected:(Required)