24/7 Emergency & Referral Vet Mississauga, ON

Patient Name *

Approx Weight (kg) *

Breed *

Sex *

Age (Years) *

Colour *

I am the lawful owner or duly authorized agent for the owner of Bubba; all other legal owners have been consulted and I/We consent to this procedure, which I understand will result in a humane euthanasia for Bubba with the help of a veterinarian at this practice. *

To the best of my knowledge, my pet has not bitten any person or animal within the past 10 days. *

Do you wish to be present at the time of euthansia? *

Yes, I wish to be present
No, I do not wish to be present

Euthanasia Consent Form

OWNER INFORMATION

PATIENT INFORMATION

AFTERCARE OPTIONS