Euthanasia Consent Form

I, the undersigned, hereby state that I am the legal owner or legally authorized representative of the legal owner of the above listed pet and authorized to make all medical decisions regarding this pet.

I have declined any further care for the above pet and am hereby authorizing Animal Medical Center of Mid-America to euthanize the above listed pet.

I agree to have Animal Medical Center of Mid-America choose a euthanasia protocol at their sole and exclusive discretion; and I do hereby forever release Animal Medical Center of Mid-America and its agents, servants or representatives from any and all liability for so euthanizing the above listed pet.

I do also certify that the above listed pet has not been exposed to rabies and has not bitten any person or animal in the last 10 days.