Euthanasia Request Form

Save time before your mobile veterinary appointment! Complete your euthanasia request form online from any device at any time before we visit.

Get Started

Euthanasia Request Form

Please fill out this form as completely and accurately as possible so we can get to know you and your pet(s).

Saturday and Sunday euthanasia visits are by appointment only. Limited appointments are available. If this is an urgent matter, call or text 785-813-2853 after you submit the Euthanasia Request Form, and we will respond as soon as possible. If you are reaching out after hours or on a weekend and do not hear back from us within 30 minutes, please follow up with Blue Pearl Overland Park, (913) 642-9563.

Owners Name *

First

Last

Phone *

Email *

Website request will be answered by email. Please provide an email address that is checked regularly.

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Pet's Name *

Sex *

Age *

Breed *

Weight *

Color

Regular Veterinarian

How Did You Find Us?

Reason for Euthanasia Request: *

What type of aftercare do you desire for your pet?

Private cremation (Ashes returned)
Communal cremation (No ashes returned)
At home burial (Please review local laws for burial in your area.)

Would you like any keepsakes from your pet? (Keepsakes are available only when electing to have private or communal cremation for your pet.)

Clay paw
Ink paw print
Ink nose print
Fur heart keepsake

Most euthanasia visits are scheduled after our normal appointment hours M-F, or on weekends. What date/time do you prefer for this visit? *

Date

Time

I understand that calls, texts, and emails are not monitored 24/7 and that if this is an urgent matter, I will call or text 785-813-2853 after submitting the Euthanasia Request Form. If I am reaching out after hours or on a weekend and do not hear back from Hall Veterinary Services within 30 minutes, I should follow up with Blue Pearl Overland Park, (913) 642-9563, or another local ER facility.

you local What

I Understand and Agree

Euthanasia Request Form

Euthanasia Request Form

Request A Mobile Visit

Make An Appointment

Have a Question?

Mailing Address

Contact Information

Hours

If you require an urgent euthanasia, please fill out the Euthanasia Request Form.