▷ Client Cremation Authorization

Location of Animal Remains: *

Pet's Name *

Date / Time *

Breed Type: *

Pet Weight: *

Pet's Owner: *

First

Last

Address *

Address Line 1

Address Line 2

City

State

Zip Code

have apply:

Email *

Phone

Does your pet have a pacemaker? *

Yes
No

Please note that any item you send with your pet (blankets, pillows, carriers, etc) will be assumed to be included with the cremation of the pet. Be sure NOT to release pets with items that you wish to maintain as keepsakes. Loyal Souls Pet Cremations is NOT responsible for unreturned items.

Pick all that apply: *

PRIVATE: Only pet in chamber, ashes returned to owner
COMUNAL: Cremains not returned to owner, but spread in a natural setting
REMOVAL: Weekday Night - Extra fee may apply
REMOVAL: Weekends/Holidays -Extra fee may apply
REMOVAL: Out of Town - Extra fee may apply
RUSH SERVICE (24 Hours)
Clay Paw Print
Engraved Name Plate
Lock of Fur

Additional comments or requests:

I authorize the release of the deceased animal mentioned above to Loyal Souls Pet Cremations for the cremation of the type selected above.

I certify that the animal has not bitten anyone in the past 15 days. I agree to pay all fees and charges incurred for the cremation process.

I also agree to allow a representative of Loyal Souls Pet Cremations Service to spread the ashes if I do not arrange or follow through on picking up my pet's cremains within 30 days from the date this form is submitted.

Signature *

I am the: *

Owner

Custom Captcha *

=

Client Cremation Authorization

Release of Deceased Animal Remains