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Amy Ehrmentraut, DVM
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Serving the Foothills and Denver West of I-25
Euthanasia and Aftercare Consent Form
First name
Last name
Address
Email
Phone
Referral
Animals name
Male
Female
Breed
Approx age
Weight
Clinic name
Presenting condition
Euthanasia – humanely terminate life
BODY AFTERCARE REQUESTS
I choose to retain my pet for burial. (regulations have been discussed)
I choose communal cremation
I choose private cremation
I would like a paw print keepsake
Other special requests
Your Signature
clear signature
Date
Submit
Thanks for submitting!
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