Consent for Euthanasia

I certify I am the legal owner or authorized agent for the owner of the pet and give Eden Veterinary, and any authorized agents, staff, or representatives, full and complete authority to euthanize my pet. I forever release and hold harmless Eden Veterinary and any authorized agents, staff, or representatives from any and all liability for euthanasia and aftercare.

To the best of my knowledge, my pet has not bitten, scratched, and/or potentially exposed any person or other animal to rabies in the past ten (10) days. I understand that if the animal has bitten or otherwise potentially exposed any person within the time specified, a rabies test must be performed.

I understand euthanasia is the act of ending the life of an animal in a humane way to prevent unnecessary suffering. I understand there are certain risks and complications that can arise, and I may request more information before starting the process. I hold Eden Veterinary and all authorized agents harmless for any emotional distress that may arise due to complications. To the best of my knowledge, the information I have provided is accurate and complete. Fees have been explained to me and I assume full responsibility for all charges.

 

Authorization for Sedation (Drugs & Routes)

I authorize the veterinarian to administer pre-euthanasia sedation and/or anesthesia using tiletamine-zolazepam (Telazol) or an analogous drug, with or without acepromazine, by subcutaneous (SQ), intramuscular (IM), intravenous (IV), or other routes as deemed necessary. I understand drug selection and route may be adjusted based on my pet's condition, temperament, and comfort; that sedation may cause loss of balance, loss of airway reflexes, or paradoxical reactions in rare cases; and that an IV catheter may be placed at the doctor's discretion.

 

Doctor's Discretion to Decline or Stop

The veterinarian may decline to proceed with euthanasia or may modify or discontinue the procedure at any time if, in their professional judgment, legal, safety, medical, ethical, or identification concerns exist. In such cases, the veterinarian may recommend alternative care, additional sedation, rescheduling, or referral.

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Irreversibility Once Begun

Once the euthanasia portion of the procedure is administered, it is irreversible. After pre-euthanasia sedation is given, safe reversal may not be possible, and completing humane euthanasia may be medically necessary to prevent distress or suffering. Once the process has begun it cannot be stopped or reversed.

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Client-Handled Remains — Hazard & Legal Notice

If you elect to handle aftercare yourself, animals euthanized with barbiturates (e.g., pentobarbital) present a serious hazard to wildlife, pets, and scavengers. No other animal should have access to the remains at any time. You are solely responsible for complying with all applicable local and state laws regarding storage, transport, burial depth/location (including setbacks from waterways), and any required permits.

 

Cancellation & Refund Policy

Cancellations should be made as early as possible. More than 24 hours before: partial refund with 5% service fee deducted. Within 24 hours but more than 3 hours before: $100 cancellation fee. Within 3 hours: $250 cancellation fee. Full refunds are not available. As an alternative, you may keep the remaining balance as credit for future services.

 

After-Hours Policy

Additional fees apply for evening and weekend appointments: +$200 from 6:00pm–9:00pm, +$800 from 9:00pm–9:00am, +$300 for weekend appointments. If two qualifiers apply, they are stacked. All fees are due at the time of service.

 

Electronic Records & Signature Disclosure

By checking the consent box to access the payment page and completing payment, you agree to conduct this transaction by electronic means and to receive all notices, disclosures, authorizations, and other documents electronically from Eden Veterinary. This includes this consent form, appointment confirmations, receipts, and aftercare documentation.

Requesting paper copies. You may request a paper copy of any electronically provided document at no charge by emailing info@edenveterinary.com or calling (424) 272-0345. Please include your full name and the document you are requesting.

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You may withdraw your consent to receive documents electronically at any time by emailing info@edenveterinary.com with the subject line "Withdraw Electronic Consent" and including your full name, email address, and phone number. Withdrawing consent to electronic records and signatures does not withdraw your consent to the services or any other terms you have agreed to. If you withdraw consent, future documents will be provided in paper format, which may delay scheduling and service delivery.

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If your email address or other contact information changes, please notify Eden Veterinary by emailing info@edenveterinary.com as soon as possible so that we can continue to reach you.

Hardware and software requirements. To access and retain electronic records, you need a device with a modern web browser (Chrome, Safari, Firefox, or Edge) and the ability to view or save PDF files. You confirm that you currently have access to such a device and software.

 

By proceeding to the payment page (you will be directed away from this website to a payment page):

You certify that you are the legal owner of the pet or the authorized representative of the owner acting with their express permission. You acknowledge that you have read, understood, and agree to all terms on this page. Payment constitutes your electronic signature and consent to these terms under ESIGN and UETA.