Veterinary Pet Cremation Authorization Form

Veterinary Office
Pet Cremation Authorization Form

Section 1: Veterinary Office Information

Vet Business Name

Vet Address

Vet Contact Name

Vet Email

Vet Phone Number

Vet Internal Tracking

Section 2: Pet Owner & Deceased Pet Information

Pet Owner First Name

Pet Owner Last Name

Pet's Name

Pet Breed

Date of Death

Pet Weight lbs (whole number)

Pet Color

Section 3: Selection of Services & Keepsakes

Eco-Friendly Water Cremation Selection

Communal Cremation where multiple pets are present in the cremation vessel without any form of separation. The cremated remains are not available for return to the owners.

Individual Cremation where each pet is isolated in their own stainless steel chamber during the water cremation process and each pet's individual cremated remains are available for return to the owner.

FaceTime Farewell

Yes

Facetime Farewell Phone Number

Custom Keepsakes

Clay Paw Print Qty

Names greater than 7 characters may appear on two lines

Clay Paw Print Name

Glass Vial of Hair Qty

Cremation Jewelry Keepsakes

Choice 1 Qty

Choice 2 Qty

Choice 3 Qty

Choice 4 Qty

Specialty Urn Selections

Urn Qty

Section 4: Receipt of Pet's Cremains

Receipt of Pet's Cremains

Crematory will deliver to Veterinary Office

Veterinary rep will pick up at Crematory

Customer will pick up at Crematory

Crematory will deliver to Customer $45 (alternating Wednesday evenings 6-9pm)

Section 5: Receipt of Cremains Information (if needed)

The form will let you know if these fields are required based on Section 4 selection

Pet Cremains Receipt Name

Pet Cremains Receipt Mobile Phone

Pet Cremains Delivery Address

Section 6: Special Requests

Special Instructions

Veterinary Office Pet Cremation Authorization Form

Veterinary Office
Pet Cremation Authorization Form