appointment – The Comfort Krewe

First Name

Last Name

Street Address *

Apartment, suite, etc

City

State/Province

ZIP / Postal Code

Phone *

Our preferred first contact is text message as we are driving or in appointments most of the day, and this method can be done safely and quickly in between appointments. We can certainly also call you after text contact, but likely will be towards the end of our day when we are no longer driving. Please indicate if your phone is a landline and you are unable to accept text messages (again, phone calls may have to wait until the end of the day).* *

Email Address

Pet's Name *

Type of Pet *

Please choose the gender of your pet. *MaleFemale

Neutered/Spayed?YesNo

Age of your pet *

Weight of pet (in pounds, can be approximate) *

If your pet is a specific breed, please list it here.

Reason for euthanasia (mobility, old age, cancer- what type or source, kidney disease, etc). Feel free to be as detailed as you wish.

Please list all medications you are currently giving to your pet, including dose and how often. *

Do you need cremation service as well? *Yes, and I wish to have the ashes returned to me (private cremation)Yes, but I not wish to have the ashes returned to me (communal/group cremation)No, I am taking care of the body myself. I understand that there may be laws requiring appropriate burial/disposal of my pet that I will be responsible for.

How soon are you wishing to have a home visit/appointment scheduled? *Today – my pet’s condition cannot wait longer than today for assistance. Please note this may not be available – we will contact you as soon as possible to let you know.Next availability for my area, likely within the next few days In the next weekA specific date within the next 2 weeks – you can let us know the date when we contact you.

Has Dr. Lynn helped you in the past with another pet?

This form is for families that are ready to schedule an appointment and need information about available dates/times. Please make sure to review our service area and pricing schedule on our website prior to submitting an inquiry.