"*" indicates required fields

  • 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:
MM slash DD slash YYYY