At Home EuthanasiaSchedule compassionate at-home euthanasia "*" indicates required fields Step 1 of 4 25% Are you a registered Client with us?* Nope, this is my first time Yes, I’m back for more services. Name (as presented in Passport or Gov. ID)* First Last Email* Enter Email Confirm Email Phone*Local Phone or WhatsApp NumberOwner InformationTo serve you we’ll need some information.Where will we be visiting you? Please fill out your home address below as accurately as possible.Address* Street AddressAddress Line 2* Address Line 2District*— Select Below —Bodden TownEast EndGeorge TownNorth SideProspectWest BayRed BayRum PointSavannahSeven Mile BeachSouth SoundPlease choose your nearest districtIsland*Grand CaymanCurrently only available in Grand CaymanPostal Code* KY1-1234Country*Cayman IslandsCurrently only serving Cayman IslandsHow did you find out about us?*— Select Below —GoogleInstagramFacebookReferral from ClinicReferral from a friend or familyOtherI'd rather not sayWe’d love to know how you heard about us!Which Clinic?* Who was it? We’d love to thank them 🙂Other How else? Pet QuestionsIs your pet registered with us?* Yes No Pet InformationPlease let us know a little bit about your beloved pet.Pet's Name* Pet’s Full NameDoes your pet bite?* Yes No I’m not sure. Pet Species*— Select Below —Canine (Dog)Feline (Cat)Avian (Bird)Other (Please Specify)What species are we looking at?* Breed* Do you know your pets birthdate?* Yes No Birthdate* dd/mm/yyyyApproximate Age* Can you give us your best guess?Years / Months*YearsMonthsPet Weight* If you’re unsure, give it your best guess.Unit for Weight*KG (Kilograms)G (Grams)LBs (Pounds)Microchip Number Were you referred to us by a Clinic?* Yes No Which Clinic?* Upload Medical Record Drop files here or Select files Accepted file types: jpeg, jpg, pdf, png, Max. file size: 5 MB, Max. files: 5. If your pet has a medical record. Please upload it here.Anything else we should know? The Home StretchJust a few more things.Preferred time of visit*— Select Below —Morning (Typically between 9a-12p)Afternoon (Typically between 1p-4p)Anytime worksBeing a Mobile Vet we unfortunately cannot carry your pet with us. However, there are a few options that we provide for you to choose from. Please visit At Home Euthanasia page for more information.Pet Aftercare*— Select Below —Home BurialPrivate Cremation with or without Ashes BackDepartment of Environmental Health Pickup and CremationNot sure, and would like to discuss further.Method of Payment* Cash Debit / Credit Card Payment is due in full at the time services are rendered.Consent and SignaturePlease review the information below.Privacy Policy Consent* I agree to the privacy policy.Terms of Service* I have read and agree to the Terms of Service1. I am the owner (or authorized agent) of my pet. I hereby authorize and direct Eco Planet Ltd T/A The Mobile Vet Company; its veterinarians, technicians, and assistants to perform services, vaccines, treatments, diagnostics, and/or administration of extra label medications as deemed necessary or advisable in connection with or relating to the matters described in the attached estimate or the matters that have otherwise been explained by Eco Planet Ltd T/A The Mobile Vet Company; veterinarian or other staff.2. I understand that there is a risk of complications with every procedure, including the possibility of death as a severe complication of surgery, anesthesia, or other procedures. I also understand that there is no guarantee as to the results of any procedures, diagnostics, vaccines, or treatments. I understand that I may ask any questions that I have regarding any procedure, diagnostic, vaccination, or treatment recommended by Eco Planet Ltd T/A The Mobile Vet Company; veterinarian before it is performed.3. I authorize Eco Planet Ltd T/A The Mobile Vet Company to obtain all medical records regarding my pet from other veterinary hospitals as needed.4. I understand that Veterinary Technologists/Veterinary Technicians/Veterinary Nurses/Veterinary Assistants may perform certain functions in the preparation and care of my pet even when a veterinarian is not present5. I understand and agree that portions of my visit or the care and treatment of my pet may be recorded for security purposes.6. I understand that payment is due in full at the time that services are rendered. If for any reason payment is not made at the time services are rendered or within ten days after, I understand that my account may be referred to a collection agency. In the event that my account is referred to a collection agency, I agree that Eco Planet Ltd T/A The Mobile Vet Company may add an amount to my outstanding account balance to reimburse Eco Planet Ltd T/A The Mobile Vet Company for the reasonable collection charge imposed by the collection agency. Eco Planet Ltd T/A The Mobile Vet Company does not request or require personal information as a condition to payment by credit card, but card users may be required to provide proof of identity.7. Eco Planet Ltd T/A The Mobile Vet Company provides a mobile clinic for house call examinations and treatments to be performed in. If I request an examination and/or treatment be performed in my household Eco Planet Ltd T/A The Mobile Vet Company, its veterinarians, technicians, and assistants are not responsible for damage to property or personal items which may occur during the course of said visit.8. Professional restraint will always be provided by Eco Planet Ltd T/A The Mobile Vet Company veterinarians, technicians, and assistants. If I refuse the professional restraint of my pet provided, Eco Planet Ltd T/A The Mobile Vet Company and its veterinarians, technicians, and assistants are not responsible should I be injured by my pet.9. I understand that there is a risk of reaction with any vaccination. Vaccination reaction symptoms can range from mild to severe anaphylaxis or even death. If my pet requires emergency treatment for a vaccine reaction I authorize Eco Planet Ltd T/A The Mobile Vet Company to provide medical care and treatment they deem necessary and understand that I am responsible for the cost of said emergency care and treatment. **PLEASE NOTE: Due to the nature of our business operation, the Mobile/Booking Fees for missed (including missing pets and pet guardians), late, cancelled or rescheduled appointments will be billed as a cancellation fee of $50. Please ensure you and your pet are present for your confirmed appointment. 24 hours required.Euthanasia Consent* I have read and agree to the Euthanasia ConsentI, the undersigned, am the legal owner (or authorized agent for the owner) of the animal listed above. I hereby authorize Eco Planet Ltd T/A The Mobile Vet Company to euthanize this animal, and release the doctor and all representatives from any and all liability for the euthanasia of said animal. I understand that payment is due at time of services rendered.Signature*This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.NameThis field is for validation purposes and should be left unchanged.