Euthanasia Consent Form

Authorization for humane euthanasia

01

Owner & patient

02

Authorization

I certify that I am at least 18 years of age and am the owner of the animal described above, or am authorized to act on the owner’s behalf. I authorize the veterinarians and staff of this practice to humanely euthanize this animal. I understand that euthanasia is permanent, and that it will be performed in accordance with accepted veterinary practice.

Bite history
03

Aftercare

04

Keepsakes

05

During the procedure

Necropsy
Please initial each statement
  1. I have had the opportunity to ask questions and to discuss alternatives to euthanasia.
  2. I understand the remains will be handled according to the aftercare option selected above.
  3. I accept responsibility for the fees for euthanasia and the selected aftercare.
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Owner / authorized agent signature
✕
Staff witness signature
✕
Veterinarian signature