Authorization Form - Compassionate Pet Transport

Compassionate Pet Transport

Deceased Pet Transport - Authorization Form

t. (310) 505-4629

Please review your information before submitting

First Name

Last Name

Phone Number:

Address

City

State

Zipcode

Species

Pet Name

Date of Loss

Time of Loss

Deceased Pet Status

Transport Information:

Origin Facility Name

Origin Contact Name

Origin Facility Address

Origin Facility City

Origin Facility State

Origin Facility Zip Code

Destination Facility Name

Destination Facility Purpose

Destination Facility Address

Destination Facility City

Destination Facility State

Destination Facility Zipcode

Estimated Pick-up Date

Estimated Pick-up Time

Additional Information

(1) A separate contract will be provided by Compassionate Pet Transport outlining the full scope of services, fees, and terms of the transport.
(2) This authorization form simply grants permission for Compassionate Pet Transport to take possession and transport your pet's remains.
(3) Estimated Pickup Date: This is an estimate and may vary depending on unforeseen circumstances.

Authorization

I, the client named above, hereby authorize Compassionate Pet Transport to take possession of the deceased remains of my pet, as described above, from the Origin Facility above. I understand that Compassionate Pet Transport will transport the deceased remains to Destination Facility located at the address listed above. I acknowledge that I am responsible for ensuring the deceased remains are prepared for transport in accordance with the instructions provided by the Origin Facility (if applicable) and any relevant regulations.

Signature

Date Signed