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Authorization For Pickup

Pet Funeral & Cremation Service of NYC
Toll Free: 800-607-1582
New York: 212-899-5606
Westchester: 914-603-1500
www.nypetscremation.com

Authorization For Pickup Form

(Please fill out all fields highlighted in yellow only!)

I, , owner of pet described below:

Name of pet:*

Type of animal:*

Where the pet is currently located:*

Veterinarian

Home

Name of pet clinic or hospital:*
Phone #:*

Address:*

Address:*

City/State/Zip Code:*

Requests Pet Funeral & Cremation Service of NYC to provide transportation back to your facility.

Date:*
Signature:* Draw Signature
(Signature of Pet Owner)

If you are done filling data into all fields, please submit the form (once submitted information can not be edited)