Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
Physical Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
My pet's name:
*
My pet is a:
*
My pet's breed:
*
My pet's color:
*
My pet is:
*
My pet's most recent or approximate weight:
*
Please indicate any current illnesses or issues that your pet is dealing with.
*
How soon would you like to schedule an in-home visit?
*
Vet Connection's in-home euthanasia services typically range from $200-$350, with additional costs based on your pet's size and your location.
In regard to aftercare of my pet's body, I would like:
*
Vet Connection utilizes a process called aquamation, which is an eco-friendly cremation alternative providing remains very similar to those produced by traditional cremation.
Learn more here: https://aquamationinfo.com/process/
I would like to purchase an additional clay paw print - $50
*
If you have chosen to have remains returned to you, one clay paw print is included. If you would like an additional paw print, or if you have chosen not to have remains returned but would like a clay paw print, please select yes.
If you have chosen to have remains returned to you, please choose from the following options.
*
All options pictured at the bottom of this page.
Please indicate any concerns or special requests that you may have.
Is there anything else that you would like us to know about your pet?
Thank you for filling out this form. We know that this is a difficult time. If we have not confirmed an appointment time with you, please reach out via email, text or call when you are ready to do so.
830-777-6500
info@yourvetconnection.com
