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Home
About
Services
At-home Euthanasia
Chinese Acupuncture
Herbal Medicine
Energy Balancing
Essential Oils
Food Therapy
Sound & Vibration Therapy
Supplements
Fees
Contact
Testimonials
Forms
For Vets
Euthanasia Consent Form
Euthanasia Consent Form
Your Name
First
Last
Email
Address
*
Street Address
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Armed Forces Americas
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State
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*
Pet's Name
Weight of Pet
Breed
Sex
Age
I certify that I am the owner of:
*
I also certify that this pet has not bitten a person or animal in the past ten (10) days and, to the best of my knowledge, has not been exposed to Rabies.
*
Yes, I certify this as true
Regular veterinarian name and hospital
*
I give Dr. Becca Klobuchar with Zen Pet complete authority, in the peaceful and humane passing of this pet and release Dr. Klobuchar from any and all liability.
*
Yes
Cremation
Private - ashes returned
Communal - ashes are not returned
I will be responsible for body care
Paw Print
None
Clay Paw Print
Ink Paw Print
Both
Hidden
Clay Paw Print
Yes
No
Please type name below and submit form to complete authorization
*
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