Euthanasia is always a difficult choice.  We at Emerson Animal Hospital realize this and are willing to help our clients through this difficult time.  Because completing this form in our office is often heart rending, I have decided to make it available on-line so that it may be completed in the comfort of your own home when the need arises.

At Emerson Animal Hospital, we only euthanize pets that are terminally ill or so old they cannot function properly and have no quality of life.  If your pet has reached this point, and you have decided you cannot allow suffering to occur, call our office and we will consult with you.

We do not do convenience euthanasias!

We do not do euthanasias for non-clients. 

We only euthanize pets too old or too ill to maintain quality of life.  This is determined by the doctors at Emerson Animal Hospital following discussion with the pet's owners.  We also offer euthanasia to those clients whose pet is vicious and a threat to family, friends or potential new owners.  This is done for public safety.

Click Here for Printable Euthanasia Authorization Form

Authorization For Euthanasia

Client Name: ________________________________________________________   

Address:____________________________________________________________

City:  ___________________________    State: ____________ Zip: _____________

Home Phone:  __________________     Work Phone: _________________________

Animal Name:  _________________    Species: __________  Sex:     Male     Female

Breed:  __________________________     Color: ____________   Age: _________

I, the undersigned, certify that I am the owner, or duly authorized agent for the owner, of the animal described above.  I do herby give Emerson Animal Hospital, its veterinarians, staff and agents complete authority to euthanize and dispose of the animal described above.  I release Emerson Animal Hospital, its veterinarians, staff and agents from any and all liability for euthanasia of said animal.

I understand that euthanasia involves administering an intravenous injection of sodium pentobarbital causing painless and irreversible death of the animal described above.

I certify, to the best of my knowledge, the above described animal had not bitten or scratched any person or animal during the last fifteen days and had not been exposed to rabies.

Signature:____________________________      Date: _________________