Euthanasia Authorization Form

Thank you for entrusting Creekside Veterinary Hospital with this deeply personal service. Please complete our Euthanasia Authorization Form to help us provide compassionate, respectful care for your pet and support you during this difficult time.

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How to Complete the Form

We understand this is not an easy step. The form is designed to be clear and straightforward. Simply:

Provide your contact information
Confirm your pet’s details
Review and acknowledge the authorization and aftercare preferences

Once submitted, our team will review the form and be with you every step of the way.

Euthanasia Authorization Form

Owner Name *

First

Last

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Phone

days, Species

Email *

Patient *

Species *

Breed *

Age *

Colour *

Reason for Euthanasia *

I, the undersigned, do hereby certify that I am the owner (duly authorized agent for the owner) of the animal described above; that I do hereby give Hospital Owner, DVM, his agents, servants, and representatives full and complete authority to euthanize the said animal in whatever manner the said Doctor, his agents, servants, or representatives shall deem fit. *

I have read and agree to the above statement.

I do hereby, and by these presents forever release the said Doctor, his agents, servants, or representatives from any and all liability for so euthanizing the said animal. *

I have read and agree to the above statement.

I grant permission for an autopsy or other procedures at the attending veterinarian’s discretion *

I have read and agree to the above statement.

To the best of my knowledge, this animal has not bitten any person or animal in the last 15 days, and has not been exposed to rabies. *

I have read and agree to the above statement.

Special Final Care Instructions *

Private Cremation
General Cremation
Owner to Take Remains

Authorized Signature *

Clear Signature

Date *

Information about the Euthanasia Process

Now that you’ve made the hard, but humane, choice to put your aging or ill pet to sleep, you may have questions.

Will it hurt? Can I be with my pet during the process?

Knowing the facts can help you and your family feel more at peace with what's going to happen.

You will have a private exam room to be with your pet for as long as you need, and we will try to accommodate any special requests.

We will have a blanket in the room, but it’s often soothing for your pet if you bring a blanket or toy from home.

The following is the in-clinic process:
1. Signing the Consent Form: You will need to read a document, confirm ownership, provide a form of ID (Driver’s Licence, Passport, etc.) and sign at the bottom. This document also has a place for you to select whether you’d like a Communal Cremation or a Private Cremation. There are also options for having memorabilia of your pet made.

2. Payments: A lot of people find it easier to pay before, as it allows you to spend as much time as you want with your beloved pet in a private room and then leave from there. However, there is no obligation to pay now; you are welcome to pay at the end if you prefer.

3. Placing the IV Catheter: We briefly carry your pet back to the treatment area to place an IV catheter. The time taken for this process can vary depending on how easily the catheter can be placed. It may take from a few minutes up to 30 minutes for very small, weak, or ill patients. This step is important to make sure the final drug is delivered straight into the bloodstream.

4. Sedation: Once you sign the consent form and the IV is placed, your pet will be given an injection to make them calm and sleepy (sedated). It may sting a little bit, or they may vomit if they have recently eaten, but there is often no reaction. It will then take anywhere from 2 to 20 minutes before your pet is in a relaxed sleep. Once your pet is asleep, you can decide whether you would like to say goodbye now or stay for the final injection.

5. Injecting the Final Drug: We will bring your pet back into the exam room to administer the final drug. This will quickly shut down heart and brain functions, usually within a minute or two. When your pet passes, their eyes may not fully close, they may urinate or defecate, or you may see them twitch or take a final breath. This can sometimes be startling, but it is a normal part of the process and most importantly your pet is not in pain. The doctor will then use a stethoscope to confirm they have passed on.

During this time, you can stay with your pet for as long as you would like, and we will proceed to the next step when you’re ready.

After you leave the hospital, we will look after your pet by notifying the cremation company to carry out your wishes on your pet cremation.

You will also receive an email of condolence from Gateway Pet Memorial containing a link to your pet’s cremation profile, where you can select if you’d like any memorabilia of your pet such as paw print, or what type of urn if you opted for private cremation.

Signature *

Clear Signature

Date *

Name *

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Need Immediate Support?

If you need urgent assistance or would prefer to speak with someone directly, please call 403-274-6633. For questions or follow-up support, you may also email info@creeksidevet.ca.

Euthanasia Authorization Form

How to Complete the Form

Euthanasia Authorization Form

Information about the Euthanasia Process

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