Download printable Euthanasia Authorization Form here.
Equine Information
BEHS-Name:
Description of condition/injury/illness that led to decision to euthanize:
Foster Information
Name:
Phone Number:
Address:
City, State, Zip:
Foster Home Comments:
Veterinarian Information
Name:
Phone Number:
Address:
City, State, Zip:
Veterinarian Comments:
Date euthanasia performed: _________________________________________
Location: ________________________________________________________
Signatures
I, the undersigned officer or director of Bluebonnet Equine Humane Society, authorized the euthanasia of the horse based on the above comments from the veterinarian and/or foster home on this date.
Name:
Title:
____________________________
Officer/Director Signature
__________
Date