Our Pets Our Family - Consent Form

Our Pets Our Family LLC

330 E Wynbrook Dr
Oak Creek, WI 53154

(414)303-2504

www.ourpetsourfamily.com

Consent Form Form

Name

Address
Street Address

City ,	State / Province	Zip / Postal Code

Phone
Phone Type	Phone Number

E-Mail Address :

Pet's Name

Breed

Color

Age & Weight

Male/Female

Male
Female

Primary Veterinary Clinic

Euthanasia

Communal Cremation

Private Cremation

Selection

Burial
Pet Cemetery
Home

I am the owner/authorized agent, of the pet described above. To the best of my knowledge, my pet has not bitten any person or animal within the last 10 days nor has been exposed to rabies. I give Dr. Inniss permission to humanely euthanize my pet and release the veterinarian from all liability in performing this euthanasia. I give the veterinarian permission to remove the body from the premises and transport to:

Please select one: (required)

pet crematory for cremation; understanding that I release the veterinarian and crematorium from all liability in performing the cremation/burial service
I will take care of the transport/cremation/burial myself

Date :

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