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care@acompassionatefarewell.com
714-485-3517
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At Home Pet Euthanasia
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Pet Euthanasia Appointment Form
Step
1
of
3
33%
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)
Enjoys meeting new people
Calm/Indifferent
Becomes stressed or anxious/fearful
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
Time
Hours
:
Minutes
AM
PM
AM/PM
