Euthanasia/Body Care Authorization and Medical Record

Pet Euthanasia - Body Care Authorization
Physical Address *
Physical Address
City
State/Province
Zip/Postal
Physical Address is: *
Mailing Address *
Mailing Address
City
State/Province
Zip/Postal

Affirmations and Declarations

Medical Decisions *
Euthanasia Request *
Pet's Biting History *

Body Care Options

Body Care Options *
Keeping the Remains *
Group/Communal Cremation *
Indicate the veterinarian with whom you have pre-arranged to transport the body directly from home to practice and to be received during business hours.
Private Cremation *
Visiting Doctor *
Please indicate the doctor with whom you have scheduled an appointment.

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