In-Home Euthanasia Appointment Form

We understand that this is a difficult time for you, and we want to provide the most compassionate care for your pet. Please fill out the form below with the necessary information to help us prepare for the in-home euthanasia appointment.

Full Name

Phone Number

Email Address

Address (Include city, postal code, and any special instructions for locating your home)

Family Veterinarian

Pet's Name

Species: (Dog, Cat, etc.)

Age

Weight

Has your pet been diagnosed with any medical conditions? (Please provide details)

What is the main reason for considering euthanasia?

Does your pet need medication before we arrive. (Please include details)

Are there any specific signs or symptoms you’ve noticed in your pet that you would like to discuss?

Do you have any questions or concerns regarding the euthanasia process?

Preferred Appointment Time

Preferred Appointment Date

Phone

+1 (672) 822-8100

Email

vancouverhcv@gmail.com

Address

Richmond, BC