Pet's Name (required)
Pet's Sex (required)
Pet Owner Information:
Owner's Name (required)
Owner's Phone Number (recommended)
Owner's Email (recommended)
I, the undersigned, do hereby certify that I am the owner or duly authorized agent for the owner of the animal described above. I do hereby give the doctors of LONE MOUNTAIN ANIMAL HOSPITAL, their staff and representatives full and complete authority to euthanize and dispose of said animal in whatever manner the said doctors of the LONE MOUNTAIN ANIMAL HOSPITAL deem fit.
I do hereby release the said doctors of LONE MOUNTAIN ANIMAL HOSPITAL, their staff and representatives from any and all liability for euthanizing and disposing of said animal. I do also certify that to the best of my knowledge the said animal has not bitten any person or animal during the last ten (10) days and has not been exposed to rabies.
GROUP CREMATION - Craig Road Pet Cemetery cremates all pets together. This is for owners who wish NOT TO HAVE REMAINS returned back to them.PRIVATE CREMATION - Craig Road Pet Cemetery cremates pets individually. This is a seperate charge depending upon the pet's weight. Remains are returned to the owners in either a standard urn (at no extra cost) or urn of owner's choice.Craig Road Pet Cemetery KeepsakeOwner to Take Remains
Client Signature (required)
Today's Date (required)
Lone Mountain Animal Hospital to provide quality veterinary care with personal touch embrace compassionate progressive approach to needs of our patients.
We accept CareCredit as a form of payment.
6688 W. Cheyenne Ave. Las Vegas, NV 89108
Check (with Photo ID)
CareCredit (Card and PayMyProvider)