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Home Euthanasia Request
Name *
Address *
City *
Zip Code *
Email *
Phone Number *
Pet's Name *
Species	Dog Cat Exotic (please list in comments)
Weight (lbs) *
Reason for Euthanasia *
Preferred Day of the Week *
Comments

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The information in the request will be emailed directly to Dr. Landers on his phone, so he will get back to you quickly. If you are ready to have Dr. Landers come out please fill out the above form and he will contact you as soon as possible. Please fill out the Euthanasia Consent Form and have that ready to be picked up at the time of service.

If you have questions, you may email him at drlanders@homeeuthanasia.net or call us at (972) 638-7387. Because Dr. Landers is frequently meeting with clients and may not be able to answer the phone, this number will go to a voice mail and he will call you back. Email is preferred as he can review your question before contacting you back.