Name *

First

Last

Email *

Mobile Phone *

Home Phone

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Country

Is GPS reliable for getting you to this address, or would you prefer to include extra directions? *

Yes, the GPS is reliable.
I'd like to include extra directions.

List directions here

Who else is authorized to make decisions about your animal's healthcare? *

First

Last

Phone

How did you find out about our practice? If you were referred by someone, who should we thank? *

Which veterinarian clinic, if any, should we update after your pet’s passing?

Animal's Name *

Species (horse, dog, or cat) *

Breed *

Colour/Markings *

Weight *

Age/Date of Birth *

Sex *

Male
Neutered Male
Female
Spayed Female

I am requesting: *

In home euthanasia
Quality of life exam
Something else

Please Explain: *

Please indicate your decision for care of the remains or aftercare options: *

Keep the remains at home after euthanasia (home burial is subject to your local laws)
Communal Cremation (Ashes are NOT returned)
Private Cremation (Ashes returned in a vessel of your choice - cardboard scatterbox or urn)
I am not sure, I would like to discuss with someone

Home Burial Considerations

1. Be aware of the legalities of home burial at your location. It can change for each city and district, so make sure you are in accordance with your local by-laws for the location you would like to use.

2. If you are unable to bury your pet within a few hours of their death, it is advisable to keep the body in a cold storage area.

3. It is recommended to dig the hole at least 4 feet deep for a small animal, but also 4 feet above the ground water table, and cover with at least 4 feet of earth. For a larger animal, it is necessary to dig at least 6 feet deep.

4. Avoid rocky areas and tree roots.

5. Maintain a 100 foot separation from wells or waterways.

6. Also be aware of any buried water, gas, or power lines.

7. Do not bury in a low-lying area, gully, or ditch that is prone to flooding. Flooding can cause a pet to resurface.

8. You can bury your pet wrapped in a natural fibre blanket, cardboard, or wooden box. Avoid synthetic fibres and plastic bags.

9. It is especially important to make sure wild animals (or other house animals) can dig up the body. The medications used for a peaceful passing are very toxic to other animals and wildlife. Poisoning wildlife in British Columbia can be a crime. For added protection after making sure the hole is appropriately deep, you may cover the burial spot with something heavy like rocks.

Payment is due in full at the time that services are performed. We accept cash, Visa, MasterCard, Discover, and eTransfer payments. *

I have read and accept the financial policy.

Please ensure that you are directed to the "success page" after submitting this form. If you are not, please email us at larchvetservices@gmail.com in order to get your information.

Our email “larchvetservices@gmail.com” is frequently getting pulled into the junk or spam folders. We recommend adding our email address information into your email contacts so you don’t miss any important emails or reminders.

In Home Euthanasia Request Form

In Home Euthanasia Request Form

Home Burial Considerations

Questions?

Location

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