Bridger Veterinary Hospital
3104 Green Meadow Drive
Helena, MT 59602
406-443-5874
Authorization for Humane Euthanasia
As owner or duly authorized agent of the owner of the animal described herein, I hereby authorize the
veterinarian to euthanize said animal for humane reasons. I further authorize the attending veterinarian
to dispose of the remains as chosen below. To the best of my knowledge and belief, this animal has not
bitten any person during the fifteen (15) days prior to today's date.
OWNER NAME
PHONE NUMBER
ADDRESS
PET'S NAME BREED
AGE
Bridger Veterinary Clinic offers the following choices for the remains of your beloved pet.
Please indicate your selection below:
Owner to take home
Your pet can be buried in a special place you choose.
Communal cremation*
Your pet's ashes are scattered in the Elkhorn Mountains.
Private cremation*
Your pet's ashes are returned to you in a handcrafted urn.
0-30lb: $88 31-60lb: $111 61-90lb: $132 91-120lb+: $160 121-250lb+: $210
0-30lb: $210 31-60lb: $243 61-90lb: $286 91-120lb+: $339 121-250lb+: $375
These additional services are available:
Clay paw print* $28
*Prices may vary due to product cost increases.
More options directly from 406 Pet Crematory. Visit www.406petcrematory.com or call 406-582-0705
Owner Signature Date