Owner’s Name *

First

Last

Phone *

By checking this box, you consent to receive promotional, transactional, and/or informational text messages from Gadsden Veterinary Associates Emergency Care at the number provided, including messages sent by autodialer. Consent is not a condition of purchase. Message & data rates may apply. Message frequency varies. Unsubscribe at any time by replying STOP. Reply HELP for help. Privacy Policy | Terms & Conditions.

I consent

I consent

Email *

Pet's Name *

Breed *

Color *

Age *

Consent for Euthanasia *

Yes, I consent to euthanasia for my pet.
No, I do not consent to euthanasia at this time.

Post-Mortem Examination for Advancement of Medical Knowledge *

Yes, I consent to a post-mortem examination
No, I do not consent to a post-mortem examination.

Body Care Wishes *

At-home burial (Owner is responsible for burial arrangements.)
Private cremation with return of ashes
Communal cremation with no return of ashes

Has your pet bitten anyone in the last 10 days? *

Yes
No

Additional Notes/Instructions for Care or Body Handling *

Signature of Owner *

Clear Signature

Date *

Euthanasia Form

Euthanasia Form

Emergency and Urgent Visits — Walk-Ins Only

Location

Contact Details

Hours

Have a question?