Request for Euthanasia Appointment

This is only a request, we will contact you ASAP for confirmation if we are available at the time you are requesting.

We will answer your email within 24 hours.

May we text you at the primary number?

Yes

What other family members will be involved in this appointment? (Please include their names)

What dates and times are you considering for your appointment?

These are only requests for days and times, not a guarantee. No appointment has been scheduled until we confirm with you.

Are there special instructions that might help me find your home?

Where would you like us to park?

What is your pet's name?

What is your pet's breed?

What is your pet's date of birth?

Exact date of birth or estimated date of birth?

Exact

Estimated

What is your pet's approximate weight in pounds?

What color is your pet?

Please tell us a little about your pets illness. (we do not offer euthanasia for behavior or aggression, please ask your regular veterinarian for other options)

Who is your pet's regular veterinary hospital, regular veterinarian and specialist (if you have one).

We will send a report to your veterinarian(s) after our appointment.

If you were referred, please let us know who sent you so we can thank them.

Do you have pet insurance? Euthanasia may be covered under your policy

Yes

Has your pet bitten (and broken skin) a person in the last 15 days?

Yes, my pet has bitten someone in the last 15 days

No, my pet has not bitten anyone in the last 15 days

If you choose a private cremation we will email you the complimentary urn choices.

For private cremation the ashes will be available in about a week to be picked up at our office at 4005 Danbury Road in Brewster, NY. We can arrange to mail them for an additional fee.

Dr. Walling does not offer euthanasia services for behavior/aggression, please speak with your regular veterinarian about other options.

Thank you for submitting.

We will contact you to confirm/schedule your appointment as soon as possible.

(Within 24 hours)