Veterinary Euthanasia Consent Form

This is a 100% free and printable template for veterinary practices. This form is used to get informed consent from the owner to perform euthanasia on their pet and highlight the legal, medical, and ethical considerations of the procedure. Print it or download it as a PDF.

Veterinary Clinic

Euthanasia Consent Form

Date:
Owner (or Agent) Name:
Address:
Phone:
Animal Name:
Species:
Breed:
Color:
Age:
Sex:

Euthanasia Consent Statement

Owner/Agent Certification and Release:

☐I certify that I am the owner, or an authorized agent of the owner, of the above-described animal, and have the authority to order its euthanasia.
☐To the best of my knowledge, this animal has neither bitten any person or animal within the last 15 days, nor been exposed to rabies.
☐I give the attending veterinarian and their representatives full authority to perform euthanasia in a humane manner, and to dispose of the remains in accordance with clinic policy.
☐I release the veterinarian, clinic, and its staff from any and all liability for performing this euthanasia.

Disposition of Remains (Please initial one):

☐Take the body home immediately after euthanasia.
☐Communal cremation (ashes will not be returned).
☐Private cremation (ashes will be returned).
☐Hold remains pending my decision (understanding that if no decision is made within a set timeframe, remains may be cremated communally).

Special Requests or Urn/Name Plate Details (if applicable):

Owner/Authorized Agent's Signature:
Witness Signature (optional):
Date:

Download or print this template under the Customize Template section.

It is a legal document ensuring the owner or authorized agent understands the euthanasia process, associated risks, and consents to the procedure and disposition of the pet’s remains.
It provides clear communication and a formal record of the owner’s decision, helping protect both the veterinary practice and the owner by outlining legal and ethical responsibilities.
The pet’s legal owner or an authorized agent who has been granted authority to make medical decisions for the pet. A witness signature is recommended but may not be mandatory.
Typically at the time an owner (or agent) makes the decision to euthanize a pet. It clarifies final care preferences and ensures both parties agree on the procedure and follow-up steps.

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