Consent to Euthanize

October 13, 2024

Owner's First Name*

Owner's Last Name*

Pet's Name*

Best Contact Phone Number*

I, the undersigned, do hereby certify that I am the owner of the animal described above; that I do hereby give Animal Medical of Salado, his agents, servants, and representatives full and complete authority to euthanize the said animal in whatever manner the said Doctor, his agents, servants, or representatives shall deem fit.

I do hereby, and by these presents forever release Animal Medical of Salado its agents, servants, or representatives from any and all liability for so euthanizing the said animal.

I do also certify that the said animal has not bitten any person or animal during the last fifteen (15) days, and to the best of my knowledge has not been exposed to Rabies.

Please select one:

I plan to take my animal home with me for burial.

I would like to have my pet cremated and have the ashes returned to me.

I would like to have my pet cremated but would not like ashes returned.

Date Signed: October 13, 2024

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