Euthanasia Consent Form

Please read all details carefully before submitting the form. If you have any questions, please do not hesitate to contact us.

Owner Information

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Pet Information

Pet's Name *

Species *

Breed

Color

Age

Consent & Authorization

I, the undersigned, am at least 18 years old, and I am the owner/duly authorized agent for the owner of the animal described herein. I hereby consent to and order euthanasia (humane death) to be performed on this animal forever releasing said veterinarian, hospital, and all agents from any and all liability for performing said euthanasia. It is my desire to provide for my pet decent and humane after-death care, complying with all legal requirements of the area. I authorize the attending veterinarian to now dispose of the remains in accordance with hospital policy, releasing the hospital, veterinarian and agents from any and all liability for performing after-death care, with the following stipulations included: *

I verify that the above stated pet has not bitten any person or animal during the last fourteen (14) days and to the best of my knowledge has not been exposed to rabies. *

I agree

Signature *

Clear Signature

Date *

By clicking 'Submit', I agree to receive recurring informational SMS, MMS, or Email messages from FairPet Surgery Center. Message frequency may vary. Message & data rates may apply. Reply STOP to opt-out of further messaging. Reply HELP for more information. No mobile information will be shared nor sold with third parties/affiliates for marketing/promotional purposes, we do not share any client data with third parties. Your personal information is kept confidential and is not disclosed to any outside organizations, except as required by law or with your explicit consent, see our Privacy Policy and our Terms and Conditions.

Message

Euthanasia Consent Form