Appointment Enquiry Form

This form is designed to make the process of booking an in-home pet euthanasia service as smooth and easy as possible. While you are welcome to omit any details you prefer, please note that I may need to request additional information if we confirm an appointment later.

Once your form is submitted, you will receive a personal phone call from me, the attending vet, as soon as I am able. Please be patient, as any delays in communication may be due to assisting other families or being in the clinic. Thank you for your understanding during this difficult time.

Contact Details

First name

Last name

Phone

Pets Details

Pets Name

Please provide their registered name. You may also include any preferred names that you would prefer I use during the appointment.

Species

Dog

Cat

Sex

Female

Male

Breed

Age (in years)

Weight (kg)

If you are unsure give an estimated or last known weight.

Pets medications (if any)

Reason for Euthanasia

Please share a brief explanation of your pet’s condition or the reason you are considering euthanasia. This helps me better understand your situation and provide the most compassionate care for you and your pet. Detailed information is not required—share as much or as little as you wish.

Pets Temperament

To ensure a safe, peaceful, and stress-free experience for you, your family, and your beloved pet, I kindly ask for information about your pet’s temperament.

I understand that pets in pain or discomfort may not feel like themselves and can sometimes become more anxious or reactive than usual. There is absolutely no judgment if your pet is more reactive; I know that pets often react out of stress and fear, and I approach every situation with compassion and understanding.

Knowing your pet’s behavior helps me prepare and make all necessary accommodations to keep everyone as comfortable and calm as possible during the appointment.

Single choice

Friendly - My pet is generally friendly with people, including strangers.

Anxious - My pet tends to be anxious or nervous around people and strangers but has not tried to lunge or bite

Reactive - My pet may become reactive and may bite if stressed or handled incorrectly.

I am unsure and would like to discuss further with the vet prior to my appointment

Appointment Information

Preferred date and time

Whilst I endeavour to ensure I can accommodate specific times and dates I may need to discuss this further with you on our call. If you don't have specific preferences you can leave this blank.

Number of people to be present

Location

You can share either your suburb or full home address of your home. If only a suburb is provided, I will request the full address when confirming your appointment.

Any details on specific parking or entry requirements are appreciated.

Special requests

If you have any special requests for your pet’s appointment, please let us know. Examples may include:

• A specific location in your home or yard for the appointment.

• Allowing extra time for family members to say goodbye.

• Accommodations for religious, cultural, or personal rituals.

• Assistance with handling a larger or mobility challenged pet.

While I will do my best to honor all requests, I may discuss them with you further to ensure I can meet your needs and provide the most compassionate care possible. Thank you for sharing what matters most to you and your pet.

Regular veterinarian Information

I kindly ask for the name of your regular veterinarian so I can notify them of your pet’s passing. This allows them to update their records and provide any additional support or follow-up care your family may need. I understand this is a deeply emotional time, and I approach this step with compassion and respect, ensuring your pet’s journey is honored and their care history is complete.

If you attend multiple veterinary clinics list the ones you'd like me to contact. Or if you dont have a regular veterinarian leave blank.

After Care

Please let me know your preferred aftercare option for your pet. You can choose from the following, or if you’re unsure, we can discuss it further during our phone call:

1. Home Burial

If you choose home burial, please be sure to check with your local council for any guidelines or regulations. It’s important to note that deceased pets can pose a health risk to other animals if they are not properly handled.

2. Group Cremation (No Return of Ashes)

In a group cremation, your pet will be cremated with other pets. There will be no return of ashes or any memorial items, but it is a respectful and dignified way of honoring your pet. Please select a cremation service provider.

3. Individual Cremation (With Return of Ashes and Memorial Services)

In individual cremation, your pet will be cremated alone, and their ashes will be returned to you. You can also select any memorial services, such as paw prints or keepsake items. Please select a cremation service provider -I work closely with a few trusted services that I can recommend.

For individual cremation, you can choose whether to have me transfer your pet to the cremation service, or you can have the service pick up your pet at the end of the appointment. For pets weighing more than 40kg home collection by cremation provider is required.

4. Unsure

If you are unsure of which option to choose, I’m happy to discuss this with you further during our phone call.

Home burial

Group cremation

Individual cremation

Unsure

Cremation Service

If you have selected group or individual cremation please choose a cremation service. If you are unsure you can find recommended services on my websites home page or we can further discuss on our call.

Payment for cremation and memorial services are not included in my service and payment should be made to the selected service.