Pet Cremation Request Form

PERSONAL INFORMATION

Owner's Name*

First Last

Address*

Street Address Address Line 2 City State ZIP Code

Phone*

Email*

Pet's Name*

Species*

Breed

Estimated Weight (in Pounds)*

SERVICE OPTIONS

We offer two different cremation services for pets. Please choose one of the below options.

Choice of Cremation Service*

INDIVIDUAL Cremation - Our most popular and eco-friendly service. Your pet is placed in a personalized compartment with no mixing of the cremains.
COMMUNAL Cremation - A beautiful option for those who DO NOT wish to have their animal’s ashes returned. After cremation, the pet's ashes are respectfully scattered at sea off the coast.

Pricing details:

Individual Cremation*

1 – 25 lbs. ($185)
26 – 50 lbs. ($220)
51 – 75 lbs. ($265)
76 – 100 lbs. ($300)
101- 149 lbs. ($335)
150 lbs.+ (375)

Private Cremation*

1 – 25 lbs. ($385)
26 – 50 lbs. ($420)
51 – 75 lbs. ($465)
76 – 100 lbs. ($500)
101 – 200 lbs.+ ($650)
201 lbs. +

Communal Cremation*

1 – 25 lbs. ($50)
26 – 50 lbs. ($60)
51 – 75 lbs. ($70)
76 – 100 lbs. ($80)
101 – 200 lbs. ($150)

Any special instructions or personal requests for the cremation?

UPGRADES, URNS & KEEPSAKES

Would you like an engraved plaque for the urn?*

Maximum of 3 lines (including your pet's name), 25 characters per line, including spaces.

Yes - Black Plaque ($25)
Yes - Gold Plaque ($25)
No

Your plaque allows for 3 lines of text. Please enter them below.*

Your plaque allows for 2 lines of text. Please enter them below.*

Untitled*

Would you like a Clay Paw Print made?*

Includes your pet's name engraved on the front of the print.

Yes, add Clay Paw Print ($64.20)
No

Would you like a fur vial included with your Clay Pay Print?*

If you choose a Clay Paw Print, we can include a small vial of your pet's fur.

Yes (No additional charge)
No

Would you like an Ink Nose & Paw Print created?*

Ink nose & paw prints are available for $30 and include one sheet each for the nose and paw. Ink prints must be taken before cremation. See Buddies collection at www.MeadowHillCo.com for more information.

Yes, add Ink Nose & Paw Print ($30)
No

PICK UP & DELIVERY

Do you need Guardian to pick up your pet for you?*

No - Owner to drop off at Guardian
Yes - At hospital
Yes - At residence ($75–150 charge depending on area)

Charges may apply to pick up from a non-affiliated hospital

What is the hospital's name?*

Hospital's phone number*

How would you like to handle the delivery of the cremated remains or keepsake items?*

$0 -Owner to pick up from Guardian
$30 - UPS Ground/Home Delivery

PERSONAL INFORMATION

SERVICE OPTIONS

UPGRADES, URNS & KEEPSAKES

PICK UP & DELIVERY

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