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Euthanasia Consent Form

FF/SMM/N

FelineCanine

RELEASE & AUTHORIZATION TO PERFORM EUTHANASIA

As owner, or duly authorized agent of the owner of the animal named above, I hereby
consent to and give permission to Mendon Village Animal Hospital to euthanize said
animal.

I release Mendon Village Animal Hospital from any and all liability for the euthanasia.

YesNo
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