Euthanasia consent

Completing this form ahead of time means we can focus on caring for you and your pet on the day.

Prior to euthanasia you will need to discuss the reason for euthanasia with a staff member. You will be given the opportunity to discuss the process and ask any questions you may have.Section A - General Details Which Vet Hospital clinic do you attend:

CatDogOther

Are you the:

Legal owner of this animal, over 18 years of age

An authorised agent, over 18 years of age

Name and contact details of pet’s ownerSection B - Consent to EuthanasiaI understand that euthanasia is the act of ending the life of an animal in a painless way to prevent any unnecessary suffering. The information I have provided is accurate and complete. Fees for these services have been explained to me, and I assume full responsibility for all charges applicable to such services.

I give permission for a Veterinary Hospital Group Veterinarian to carry out euthanasia for the animal listed above

Section C - Aftercare ArrangementsFollowing euthanasia, I would like my pet’s body to be (select one)

Returned to me for home burial Cremated, but do not require ashes returnedCremated with ashes returned in a carboard boxCremated with ashes returned in a rimu casket

Engraving (only available on rimu casket) to readSection D - Associated CostsHave you been provided with an estimate of euthanasia and body aftercare costs?

Yes

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