Welcome! Euthanasia Consent Name * First Name Last Name Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone * (###) ### #### Patient Name * Sex * Gelding Mare Stallion Age * Color * Would you like Tumalo Ridge Equine to assist in making arrangements for the body to be removed? * Yes No Yes, considering cremation I, the undersigned, do hereby certify that I am the owner or duly authorized agent for the owner of the animal described above and that I do hereby give Tumalo Ridge Equine Veterinary Services, LLC and Tyler Newton, DVM and his employees or representative full and complete authority to end the life of the said animal by humane euthanasia. I acknowledge that Tyler Newton, DVM has met with me personally and discussed the euthanasia of my animal. I further understand that I assume financial responsibility for all services rendered. Again, by signing this form, I am giving permission to end the animal's life, and I have the authority to execute this consent. * Date * MM DD YYYY * I agree to electronically sign this document by typing my name. Again, we are so sorry for your loss. Thank you for taking the time to complete this form before your appointment. Please contact us with any questions.
