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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
MM slash DD slash YYYY
Time
Hours
:
Minutes
AM
PM
AM/PM
