Owner’s NameCat’s NameDate Date Format: MM slash DD slash YYYY BreedSexColourAge I am the owner of the above named cat or am responsible for it and have the authority to execute this consent. I authorize the performance of euthanasia on the above-described cat. I hereby certify that this cat has not bitten any person within the last ten (10) days. I agree that an examination of pertinent tissues or procedures may be performed to advance the medical care of other feline patients. I agree to indemnify and hold Alamo Feline Health Center and its Doctors and employees harmless from and against any and all liability arising out of the performance of the procedure referred to above. I request one of the following after care choices: Private Cremation: Each pet is cremated individually at Bluebonnet Pet Crematory and placed in a ceramic or wooden urn. The urn and a Cremation Certificate will be returned to Alamo Feline Health Center. We will notify you by phone when the ashes arrive ($99.00 + cost of euthanasia).Wooden UrnWhite Ceramic urnBlack Ceramic urn*If you do not mark which color urn you want, a white urn will be sent. Cremation: Ashes are not returned to you but are handled with care and respect by Bluebonnet Pet Crematory. ($25.00 + cost of euthanasia) Take my pet with me for personal burial (cost of euthanasia only).Signature
