Euthanasia Form

306 Veterinary Clinic in Canyon Lake, TX provides this euthanasia form to help families share important information before an end-of-life appointment. Our team approaches these moments with compassion, respect, and clear communication for pets and their owners.

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End-of-Life Care Information

Please complete this form with your pet’s information, your contact details, and any preferences or questions you would like our team to know before the appointment.

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone Number *

Email *

Pet's Name *

Species *

Breed *

Color: *

Age: *

I, the undersigned, am at least 18 years old, and I am the owner / duly authorized agent for the owner of the animal described herein. I hereby consent to and order euthanasia (humane death) to be performed on this animal thereby releasing said doctor, hospital, and all agents from any and all liability for performing said euthanasia. It is my desire to provide for my pet decent and humane after-death care, complying with all legal requirements of the area. I authorize the attending veterinarian to now dispose of the remains in accordance with hospital policy, releasing the hospital, doctor and agents from any and all liability for performing after-death care, with the following stipulations included: *

I verify that the above-stated pet has not bitten any person or animal during the last fourteen (14) days and to the best of my knowledge has not been exposed to rabies. *

I agree

Signature *

Clear Signature

Date *

Website

Euthanasia Form

End-of-Life Care Information

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