Home » Professional Partners Cremation Request Form Please enable JavaScript in your browser to complete this form.Please enable JavaScript in your browser to complete this form.Partner / Clinic Name *Staff Name *Clinic Email *Clinic ID NumberPet Parent Name *FirstLastPet Parent AddressAddress Line 1Address Line 2City— Select state —AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePet Parent PhonePet Name *Pet Species *Pet Breed *Pet Weight *Date of Death *Type of Cremation (make note below for any specific details) *Private Cremation – with returnGroup Cremation – without return Staff Name Name Urn Choice *Wooden Urn – BambooWooden Urn – CherryWooden Urn – White-Washed OakVelvet BagOther / Nothing – see note belowPrint Choice (make note below for any specific details) *Clay Paw PrintInk Paw PrintBothOther / Nothing – see note belowNote / Special Order / Engraving, etc.Submit