Consent for euthanasia *

Euthanasia is $499.

I agree

Rabies *

I certify that, to the best of my knowledge, my pet HAS NOT bitten, scratched or otherwise exposed anyone to rabies within the last 10 days.
My pet HAS bitten, scratched or exposed someone to rabies within the last 10 days.

Patients euthanized with euthanasia solution, if ingested by wild or domestic animals, can cause toxicity and death in the ingesting animal (secondary toxicosis). If I am electing to handle my pet's aftercare, I understand the following: 1) Cremation is the best method to prevent secondary toxicosis. 2) Immediate deep burial will also prevent access by scavengers. Most local regulations require 3-4 feet of depth. If electing burial I will bury deeply and follow all local regulations related to burial. 3) If frozen ground prevents immediate burial, the pet must be covered and stored in such a way that access to scavengers is prevented until deep burial can be performed. *

I have carefully read and fully understand the above paragraph.

I certify that I am the legal owner, or legally authorized agent of the legal owner, for the above-named animal. In being the owner/agent for this animal, I am authorized to make all medical decisions regarding this pet. Therefore, I do hereby give Paws at Peace Veterinary Care, PLLC full and complete authority to perform euthanasia of this animal. I release Dr. Jessica Fragola, Paws at Peace Veterinary Care, PLLC, and any authorized agents, staff or representatives of the company from any and all liability for euthanasia and disposal of said animal. *

I have carefully read, and fully understand, this consent.

By typing your name below, you are signing this consent form electronically. You agree that your electronic signature is the legal equivalent of your manual signature on this form. *

Date *

Paws at Peace Euthanasia Registration Form

Thank you for choosing Paws at Peace.

Contact Us

Phone

Email

Hours