07940 252013

Book Your Visit

First name*

Last name*

Phone*

Email*

Address*

Are there any parking restrictions or anything else we need to know about parking?

Preferred date*

Preferred time*

Time

:HoursMinutes

Gentle Paws Farewell will aim to book the appointment at the date and time requested depending on availability. If this is not possible, we will contact you as soon as possible to arrange an alternative. If any, provide some alternatives.

Your Pet’s Name*

Type of pet*

Your Pet’s Age*

Your Pet’s Gender*

Male

Female

Neutered

Your Pet’s Weight (Kg)*

For pets over 20Kg we may require some assistance with the transfer onto the vehicle following our visit.

Please provide us with a brief description of your pet’s condition

Please select your preferred aftercare service for your pet*

Individual Cremation (ashes returned) - Price includes scatter tube

Communal Cremation (non return of ashes

I would like to keep my pet for Home burial.

Unsure. Do not worry if you are not sure what you may want, we will call you and discuss the different options with you.

Please advise the name of your veterinary practice

Do you give us consent to request your pet's clinical history*

Yes

Please let us know any other comments you may wish to share with us.

Single choice*

I confirm I am this pet's legal owner, or have been authorised by the owner to act on their behalf, and all information given is true and correct to the best of my knowledge.

Single choice*

I confirm I give permission for Gentle Paws Farewell to perform a professional and peaceful home euthanasia at the specified address in this booking.

07940252013

enquiries@gentlepawsfarewell.co.uk

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