Pet Euthanasia Consent Form "*" indicates required fields Owner's Name*Phone*Pet's Name*Species*Please selectCatDogGoatHorsePigGender*Please selectFemaleFemale SpayedMaleMale NeuteredBreed*Color*Estimated Weight*I certify that I am the owner or duly authorized agent of the owner for the above named animal, and give consent to Brown's Farm Animal Veterinary Services, the doctor and staff full and complete authority to euthanize my pet. I understand that euthanasia is the act ending the life of an animal in a painless and humane way. I also certify that this animal has not bitten, seriously scratched or exposed anyone to or has been exposed to rabies within the past fifteen days. I understand that my wishes will be immediately carried out upon signing this agreement. Fees for these services have been explained to me and will be collected at the time of service. Arrangements for aftercare will be based on the wishes of the owner/agent and documented below. Please elect the following procedure(s) and initial to accept: I choose to retain my pet for burial or self-delivery for cremation (City regulations have been discussed). I choose private cremation for an additional charge. I will be notified by the crematorium when the ashes are ready for pick up in a decorative tin. I choose communal cremation and understand that ashes will NOT be returned. I would like a specialty urn at additional cost. I would like a pawprint keepsake to be made by crematorium for an additional charge.*Dogs over 80lbs may not be eligible due to size Signature*Date* MM slash DD slash YYYY