Cremation Authorization & Release of Pet Remains
Name of Pet
Type of Pet
Sex
Breed/species
Date of Birth
Date of Death
Owner's Name & Address
Your phone number:
Your email address:
Deceased pet at
Service
Urn
Cremation Authorization
: The Owner herby authorizes the crematory ot arrange the cremation of the remains
of the pet using the services of the crematiory. in providing this authorization, the undersigned represents that he
or she is the Owner or the legal representative of the Owner and has the full right and authority to arrange the
cremation and the disposition of the Animal remains. Veterinarian is herby giving authorization to release the
remains of said pet to Charm City Pet Crematory for final disposition.
Cremation Process
: The Undersigned acknowledges that due to the nautre of the cremation proces, any
material on the remains of the pet, such as collars, tags. Etc., will be destroyed if not removed. accordingly the
undersigned has removed such material or if the material is present of the pets remains the undersigned
understands it will either be destroyed or removed and disposed of by the Crematory.
Disposition of cremated remains: the undersigned directs the crematory to take the folling actions with regar to
the cremated remains of the pet
Return to Veterinarian's office
Deliver cremains Via USPS to
owner.
Other Special Instructions
Electronic Signature
Pet Owner/Authorized Individual
Date
Charm City Pet Crematory
5500 O'Donnell St.
Baltimore, Maryland 21224
410-843-3682
