Cremation Authorization Form

Pet Information:

Pet's Name (required)

Pet's Sex (required)
—Please choose an option—MaleFemale

Species (required)

Pet Owner Information:

Owner's Name (required)

Owner's Phone Number (recommended)

Owner's Email (recommended)

I, the undersigned, do hereby certify that I am the owner or duly authorized agent for the owner of the animal described above. I do hereby release the said doctors of Craig Road Animal Hospital, their staff, and representatives from any and all liability for disposing of said animal. I do also certify that to the best of my knowledge the said animal has not bitten any person during the last ten (10) days and has not been exposed to rabies.
I am the owner/agent of the described animal and have the authority to execute this consent. I hereby authorize consent of the following procedure(s):

—Please choose an option—Communal CremationCommunal Cremation with Keepsake OnlyCommunal Cremation with Clay Remembrance OnlyPrivate CremationPrivate Cremation with Clay Remembrance OnlyBurial at Craig Road Pet Cemetery OnlyRemains Returned for Personal Disposal Only

Pet Owner Signature (required)

Today's Date (required)

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