At Home Euthanasia Authorization Form

Home Euthanasia Authorization

We are so Sorry. Please know that we are Here to Support you and your family through this tough time.

Filling this out ahead of the appointment will allow us to concentrate on you and your loved one.

Please let us know how we can help. Thank you.

* Indicates required field

Name *

First

Last

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Date of Appointment/Desired Appointment (Hours: Sun-Thurs 9am-6pm - messages after hours or Fri/Sat will be returned next business day): *

Any details we need prior to arrival? *

Pet Name, Age, Breed, Approximate Weight *

Any previous anxiety or aggression at the vet? *

Is there anything that has made home visits in the past successful? *

Any concerns or questions you have about home euthanasia? *

Do you consent to treatment by Wildflower Veterinary Mobile Services, PLLC during the appointment you have requested? *

Yes No

Do you confirm that a legal family representative above the age of 18 will be at the home for the scheduled visit? *

Yes

I confirm that the pet we are treating has not been in contact with Rabies, or bitten anyone in the last 10 days. *

Yes No (has been exposed or bitten someone)

We have elected the following for aftercare: *

Electronic Signature & Date *

Know that we are thinking of you.

Submit

We Would Love to Visit Soon!

Schedule Today!

Click the tab above if you know specifically what services you need, are in our service area, and are ready to book your appointment online today!

A cancellation fee will apply to cancellations within 48 hours.

Appointment Request Form

Click this tab if you have questions, need help scheduling, or are out of our area - submitting this form will allow us to help you get what you need!

We look forward to seeing you soon!

Hours

Emails and texts are answered or returned during normal business hours when we are not in other appointments. All emails will be returned within 24 business hours, texts will be returned throughout the week as there is time.

Appointments are regularly scheduled during the following times:
Sunday: 9am - 6pm
Monday: 9am - 6pm
Tuesday: 9am - 6pm
Wednesday: 9am - 6pm
Thursday: 9am - 6pm
Friday: Closed
Saturday: Closed

email

wildflowermobilevet@gmail.com

NEW CLIENTS:
All new clients appointments are asked to schedule online (blue button bottom right) as this allows us to get your complete information and your deposit. Please email if you have any questions prior to that!

CURRENT CLIENTS:
The quickest response for current clients will be through email (wildflowermobilevet@gmail.com) or text 469-301-2973.

As Dr. Desiree and the team are often in and out of appointments, please know we do our best to respond within 24 business hours. We are NOT an emergency service.

ADDRESS:

(MAILING ADDRESS ONLY)
Wildflower Veterinary Mobile Services, PLLC
8301 Lakeview Pkwy
Suite 111-216
Rowlett, TX 75088

Please note, this is a business address and patients are not seen here.

House Call Pricing:
$85 - 0-5 miles
$105 - 5-10 miles
$120 - 10-15 miles
$145 - 15-20 miles
$165 - 20-25 miles
Greater distances may be accommodated if schedule allows, pricing depends on distance. Please email first prior to booking appointment if your home address falls outside the normal service area.

We are proud to offer house calls to your home! Wildflower proudly serves the communities of the Northeast DFW Metroplex including Rowlett, Rockwall, Wylie, Sachse, Murphy, Plano, Allen, Garland, East Dallas, Lakewood, Highland Park, and University Park.

Contact us today - we'd love to meet you!