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HOME
ABOUT US
Meet Our Veterinarians
Meet Our Staff
SERVICES
Boarding
Canine Health Care
Pet Nutritional Counseling
Pet Behavior Counseling
Feline Health Care
Pet Nutritional Counseling
Pet Behavior Counseling
Senior Pet Care
Pet Drop Off Appointments
Diagnostic Care
Dental Care
Non-Anesthetic Dental Cleaning
Surgical Services
Microchipping
Pharmacy
Pet Bathing
ONLINE PHARMACY
RESOURCES
Get Our App
Pet Health Library
New Client Center
Our Location
Promotions
Online Forms
New Patient Registration Form – Canine
New Patient Registration Form – Feline
Boarding Form
Surgery/Treatment Consent Form
Euthanasia Form
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Request A Refill
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561-582-3364
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1110 2nd Ave N,
Lake Worth, FL 33460
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Euthanasia Form
Euthanasia Form
Marked Fields are Required [*]
Date
MM slash DD slash YYYY
Owner
*
First
Last
Email
*
Pet's Name
*
Age:
*
Species
*
Breed:
*
Dr:
*
As the owner of this pet, I do hereby consent and grant the veterinarians of Lake Worth Animal Hospital and all of their employees, agents, or representatives (collectively, the "Hospital") full and complete authority for EUTHANASIA (Humane death) to be performed on this pet in whatever manner deemed fit by the attending veterinarian, and I do hereby forever release and discharge the Hospital from any and all liability. For performing said after death care with the following stipulations included.
*
I have read the above and I am in full agreement
PLEASE INDICATE YOUR DECISION FOR CARE OF REMAINS
*
Return remains for personal disposition
Private cremation
Communal cremation
Please hold remains pending our decision
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Email
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