Cremation Consent Form (Pet)
How to Submit Your Pet Cremation Form
Fill out the form below with your information and service selections
Click the "Download as PDF" button at the bottom of the form
Email the completed PDF to
pw.cremation@outlook.com
or text it to Bethany at
507-920-0726
We will review your request and contact you shortly to confirm your service details.
Owner Information
DATE:
FULL NAME:
PHONE #:
ADDRESS:
CITY:
STATE:
ZIP:
Pet Information
PET NAME:
SPECIES:
CANINE
FELINE
OTHER:
SEX:
MALE
FEMALE
BREED:
WEIGHT:
DATE OF DEATH:
VET CLINIC:
Paw Print
CLAY PAW PRINT $30 (Please note if you would like more than 1)
NO THANK YOU
Cremation Options
GENERAL CREMATION
(no remains returned to you)
PRIVATE CREMATION
+ VELVET BAG (no additional fee)
+ DECORATIVE TIN URN
Small (<20#'s $15) Medium (21-50#'s $20) Large (51-80#'s $25)
+ WOODEN URN
Small (<20#'s $25), Medium (21-50#'s $30), Large (51-120#'s $35)
+ METAL PAW PRINT VASE
Color:
Teal
Brass
Xtra Small (<5#'s $30), Small (6-30#'s $120), Medium (31-65#'s $130),
Large (66-110#'s $145), Xtra Large (111-160#'s $185)
*Engraving available on this product is $30. Required to fill out back of form
+ FRAMED PHOTO URN (WITH NAME PLATE)
Color:
Oak
Walnut
Orientation:
Vertical
Horizontal
Medium (0-80#'s $125), Large (81-120#'s $135)
Delivery Method
Pick up remains at this location
+$30 shipped directly to your door
I
hereby state I am the owner, or authorized agent of the owner, of the above mentioned and described animal. I hereby give consent to Prairie Wind to cremate the remains of my pet. Any bedding/blankets/collars or similar items or materials left with pet will be disposed of or cremated. I will come back to pick up my pet's ashes in a timely manner. If I do not come back for over 2 months, I allow Prairie Wind to scatter my pet's cremains, and hold them harmless of any and all claims to the remains. I understand Prairie Wind has the right to refuse services for any reason.
PAYMENT IN FULL, IS DUE PRIOR OF CREMATION PROCESS.
SIGNATURE:
DATE:
ENGRAVING FOR METAL PAW PRINT VASE / PHOTO FRAME
25 CHARACTERS PER LINE - THIS INCLUDES SPACES
LINE #1 -
LINE #2 -
LINE #3 -
LINE #4 -
Additional Requests
Download as PDF