Euthanasia Form

Thank you for trusting River Road Animal Hospital during this difficult time. To help us provide the most respectful and compassionate care for your beloved pet, please take a moment to complete our Euthanasia Consent Form.

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Euthanasia Form

Please complete this form as fully and accurately as possible, so we can honour your wishes and provide the care needed. We’re here to support you every step of the way during this difficult time. If you have any questions or concerns, please don’t hesitate to reach out.

Euthanasia Form

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone Number *

Email *

Pet's Name *

Species *

Breed *

Colour: *

Age: *

I, the undersigned, am at least 18 years of age and am the owner or duly authorised agent of the owner of the animal described above. I hereby consent to and request euthanasia (humane death) for this animal, and I fully and forever release the attending veterinarian, hospital, and all associated personnel from any and all liability in connection with this procedure. It is my wish to provide my pet with compassionate and dignified after-death care in accordance with all applicable laws and regulations. I authorise the attending veterinarian to manage the remains in line with hospital policy and release the hospital, veterinarian, and staff from any and all liability related to after-death care, with the following preference noted: *

I confirm that, to the best of my knowledge, the above-named pet has not bitten any person or animal within the past fourteen (14) days and has not been exposed to rabies. *

I agree

Signature *

Clear Signature

Date *

Website

Euthanasia Form

Euthanasia Form

Euthanasia Form

Location

Contact Information

Hours

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