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Pet Euthanasia Appointment Form

Step 1 of 3

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Owner Name(Required)

First Last

Your Home Address(Required)

This field is hidden when viewing the form

DistanceMiles

Travel Fee

Price: $0.00

Apt/Unit(Required)

Phone(Required)

Email(Required)

Pet Name(Required)

Species(Required)

Dog

Cat

Rabbit

Other small mammal

Please specify

Weight(Required)

Please enter a number from 0 to 150.

Breed

Gender(Required)

Male

Female

Describe to Dr. Lisa your pet's current condition(Required)

Pet's Comfort Level With New People(Required)

Additional Notes for Dr. Lisa(Required)

Euthanasia Service(Required)

0 - 99 lbs + $550.00

100 - 150 lbs + 610.00

Aftercare

Private Cremation

Group/Communal

No Aftercare

Private Cremation(Required)

Private Cremation (0-49 lbs) + $360.00

Private Cremation (50-99 lbs) + $420.00

Private Cremation (100-150 lbs) + $490.00

Group/Communal(Required)

Group/Communal (0-49 lbs) + $180.00

Group/Communal (50-99 lbs) + $280.00

Group/Communal (100-150 lbs) + $380.00

Option

Clay Paw Print

Clay Nose Print

Ink Paw Print

Ink Nose Print

Engraved Name Plate For Urn

Necklace Paw Print Urn

No Keepsakes

Total

Date

MM slash DD slash YYYY

Time

Hours

:

Minutes

AM/PM

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