I, the undersigned, hereby certify that I am the owner or duly authorized agent for the owner of the animal described below. I consent to, and order, euthanasia to be performed on that animal. I further authorize the attending veterinarian, his agents, and representative’s full and complete authority to dispose of said animal according to the laws of the State of Illinois regulating pathological disposal through Hinsdale Animal Cemetery.
I realize the attending veterinarian must pay a fee for the disposal of said animal, and do hereby and by these presents forever release the said Doctor, his agents, and representative’s from any and all liability for the performance of the euthanasia and disposal of the said animal. To the best of my knowledge and belief this animal has not been exposed to Rabies and I do also certify the said animal has not bitten any person or animal during the last fifteen (15) days preceding this date and to the best of my knowledge has not been exposed to Rabies.
We can also refer you, the pet owner, to the cemeteries for other available options.