Euthanasia Consent Form

We know that losing a pet is like losing a member of the family. We believe that all animals should receive a dignified farewell surrounded by loved ones.

Get Started

Euthanasia Consent Form

Please fill out this form completely to ensure this hardest of appointments is as peaceful as possible for both you and your pet.

Name *

First

Last

Address

Address Line 1

Address Line 2

City

State

Zip Code

Phone

Email *

Pet's Name

Species

Breed

Color

Age

As part of our effort to support you through this difficult time, we offer the option of processing payment before your appointment. Once we have received your Consent Forms, would you like Valley Veterinary Clinic of Glasgow team member to call you to receive payment?

Yes, I would like to take care of the payment prior to my appointment.
No, I will take care of the payment at the time of my appointment.

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 forever 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 my choice of after care, 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.

After Care Arrangements:

We have 3 options to facilitate your needs when deciding how you’d like to care for your pet’s remains after euthanasia. (We do not have a large animal cremation service available)

1. Take Home - If you’d like to take your pet home to bury, we have burial boxes and bags to ensure they are transported to their burial site with dignity.

Cremation Services - We partner with the NE MT Pet crematory in Miles City, MT to offer individual or group cremation depending on your wishes. You can also request to have a clay pawprint made and returned to you with either cremation option.

2. Individual Cremation- Your pet will be cremated by themselves, and their remains will be returned to you in a standard urn. Urns can be updated by contacting NE MT Pet Crematory directly.
3. Group Cremation- Your pet will be cremated with a small group of other animals and their cremains are scattered at a beautiful location around Miles City.

Signature

Clear Signature

Date

Euthanasia Consent Form

Euthanasia Consent Form

After Care Arrangements:

Ready To Visit

Questions?

Address

Contact Information

Hours

We proudly serve the pets of Glasgow, MT and the surrounding areas:

Wolf Point

Malta

Scobey

Opheim

Fort Peck

Plentywood