Client Euthanasia Authorization

Making the decision to say goodbye is never easy. Our euthanasia authorization services provide families with a compassionate, transparent process to ensure their wishes are honored. With clear documentation and gentle guidance, we help you navigate this difficult moment with dignity, respect, and care for your beloved companion.

Pet Information

Patient Name*

Species*

Breed*

Color*

Sex*

I, the undersigned, do hereby consent to, and request that, for humane reasons, euthanasia be performed on the animal described above. Further, I hereby authorize Allied Veterinary Emergency Hospital and its agents to dispose of the remains in accordance with hospital policy. I do also certify that to the best of my knowledge, the said animal has not bitten any person or animal during the last ten (10) days and has not been exposed to rabies. The cost for the euthanasia service is $228.00.
*

I agree to all of the above

Cremation Type

Please select one (add nickname for Private Cremation if you'd like):

1. Temporary hold of remains at Allied (Owners requesting a remains hold are billed for communal cremation. Pets are held for up to 7 days to provide time for arrangements to be made. After this time has lapsed, the remains will be sent for a communal cremation, and the ashes will not be available for return. Authorizing releases below Allied Veterinary Emergency and its affiliates from any liability for loss of remains.)
2. Communal Cremation (No return of remains)
3. Private Cremation (Cremated Remains returned in urn with engraved name plate. Cost based on weight scale)

*

Returned for home burial/other arrangements
Temporary hold of remains at Allied
Communal Cremation (flat rate of $104)
Private Cremation (Canine 1-10 lbs $182): include nickname
Private Cremation (Canine 11-25 lbs $208) include nickname
Private Cremation (Canine 26-50 lbs $236) include nickname
Private Cremation (Canine 51-75 lbs $332) include nickname
Private Cremation (Canine 76+ lbs $359) include nickname
Private Cremation (Feline $182) include nickname

Memorabilia

If you'd like any of the below memorabilia, please include the quantity of each. The cost is based per unit (i.e. 0,1,2,3)*

Ink Paw Print ($42.75)
Clay Paw Print ($62.75)
Necklace ($52)

Shipping

Shipping of remains is available for a flat rate of $61.75. While we do offer this service, we are not liable for any damages to the items, as they are fragile and may break during transit. Please choose this option, understanding that these items are irreplaceable and copies are not made to recreate them. Signing below releases Allied Veterinary Emergency from any liability for shipping remains.*

Yes