Request An Appointment Online - Helping Hands Pet Hospice

What county do you live in? *

Hillsborough
Manatee
Pasco
Pinellas

Pet Parent - Please use the same name you use at your vet's office *

First

Last

Address Where Appointment Will Take Place *

Address Line 1

Address Line 2

City

State

Zip Code

Is this your mailing address? *

Yes
No

Mailing Address *

Address Line 1

Address Line 2

City

State

Zip Code

What other family members will be involved in your pet's appointment?

Instructions - cross streets, house color, cars, etc that will help me find your home.

How may we help you? *

Virtual Quality of Life Consultation
House Call Euthanasia
Other

Other Request

What dates and times are you considering for your appointment?

These are only requests for days and times, not a guarantee. No appointment has been scheduled until we confirm with you.

Please tell us a little about your pet's issue *

Pet Name *

Species

Cat
Dog
Other

Breed *

Pet's Date of Birth *

Exact date of birth or estimated date of birth? *

Exact
Estimated

Weight *

Enter weight in pounds.

Color *

Sex *

Male
Female

Is your pet spayed or neutered? *

YES
NO

With your permission, we would be honored to feature your pet on our FB and IG pages. Please submit their photo here.

Click or drag a file to this area to upload.

Please save the file with your pet's first name prior to uploading

How did you hear about us?

If "other," please explain:

If you were referred, please let us know who sent you so we can thank them!

Who is your pet's veterinarian? We send a report with each appointment *

Veterinary Clinic Name (If a chain like Banfield, please put street name) *

What is YOUR email address? (please add info@hhphospice.com to your address book to avoid our emails going to SPAM.) *

What is YOUR phone number? *

Receive Texts at Above Number? *

YES
NO

Do you have pet insurance? Hospice care and euthanasia may be covered under your policy. *

YES
NO

Has your pet bitten (and broken skin) on a person in the last 10 days? *

YES my pet has bitten
NO my pet has not bitten anyone in the last 10 days.

Please explain, providing the date of the bite and the circumstances. *

Is your pet currently under quarantine for biting a person? *

YES
NO

All families will receive (if they desire) one Pawpals foam paw print impression and one lock of fur from their pet. Click the links below to preview additional items.

Please select any additional items you would like.

Additional PawPals foam paw print - $30
Additional locks of fur - $0
Clay Paw Print from Pet Angel (only available with cremation services) - $30
Ink Paw Print from Pet Angel (only available with cremation services) - $30

Additional PawPals Foam Paw Print - How many would you like?

Additional Locks of Fur - How many would you like?

Clay Paw Prints - How many would you like?

Ink Paw Prints - How many would you like?

May we help you with aftercare for your pet? *

Communal (no ashes returned to you)
Private (ashes returned)
I will be taking care of my pet's remains on my own
I want cremation but am unsure which type yet

Private cremations come with a choice of five different urns or a velvet bag at no extra charge. Your beloved pet’s ashes will be placed inside a clear bag and then a blue silk bag before going into an urn. All urns are able to be opened. The velvet bag will have only a clear bag with your pet’s ashes inside. Click the links below to preview each option. If you are not ready to make a choice or want to upgrade to a different urn, please let us know below. Engraving options will appear once you have selected an urn.

Please select an urn *

Would you like your urn engraved ($50 for up to 3 lines. Lines are limited to 30 characters including spaces)? *

YES
NO

Please select any additional items *

Etched directly into the wood ($50) - up to 2 lines of 20 characters each
Engraved brass nameplate ($50) - up to 3 lines of 26 characters each
None of the above

Please specify the message you'd like engraved in this box.

Please Note: The engraving on the Blue Metal Urn isn’t as visible as the other urns.

Where would you like to pick up your pet's ashes? *

My veterinarian's office
Pet Angel (13100 56th Ct N Clearwater - off of Ulmerton Rd between US 19 and 49th St)
I prefer to have them shipped (signature required) to my home or office - $30

Special instructions (division of ashes, upgrade urn, multiple urns, etc) may be entered here if you wish:

If your pet is 35-90 pounds, do you have one person who can safely help lift your pet on a stretcher? If your pet is over 90 pounds, do you have two people who can safely help lift your pet on a stretcher? (We may be able to provide an extra person with enough notice) *

Yes
No
My pet weighs less than 35 pounds.

If you are more comfortable having us see your pet outside, we are happy to do so in a shady, safe area. If we come into your house, we ask that you wear a mask covering your mouth and nose at all times. We will also be masked the entire time we are with you and your pet. *

I agree.

COVID-19 UPDATE

Request Appointment

Request an appointment online!

Please complete the form and we’ll get back to you as quickly as possible to confirm your appointment. If this is an emergency situation, please call us at 727-210-5517.