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?

Other Request

What dates and times are you considering for your appointment?

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

If you would like, please upload a photo of your pet. Photos may be used with your pet's first name only on social media.

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? If so, euthanasia can not be performed unless the pet is tested for rabies afterward (fee $150). *

YES my pet has bitten and I agree to the fee for testing.
NO my pet has not bitten anyone in the last 10 days.

All families will receive (if they desire) one PawPals foam paw print impression and one lock of fur from their pet. A clay paw print may be substituted for the PawPals. Please note that clay paw prints do tend to crack and shrink with time. Please select any additional items you would like

Substitute Clay Paw Print instead of PawPals - $0
Additional Clay Paw Print - $15
Additional Pawpals foam paw print - $30
Clay Nose Print - $10
Extra locks of fur - $0

PawPals prints are made of foam and are inside a case with a viewing window to protect the impression from being damaged. A photo may be inserted into the lid for display.

Additional Clay Paw Prints - How many EXTRAS would you like? (your service comes with one complimentary PawPals foam paw print keepsake)

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

Clay Nose Prints - How many would you like?

Extra Locks of Fur - How many would you like?

May we help you with aftercare for your pet?

Communal (no ashes returned to you)
Private (ashes returned to your veterinarian)
I will be taking care of my pet's remains on my own

If you want a private cremation, you may choose an urn ahead of time: (Click a picture to select the urn you prefer)

Engraving: $50 for up to 3 lines. Lines are limited to 20 characters including spaces. Please specify the message you'd like engraved in this box.

(PLEASE NOTE: Engraving on the blue metal urn is dark grey on blue, and is somewhat less visible than on all other urns)

Brass nameplate: $50 for up to 3 lines. Lines are limited to 26 characters including spaces. Please specify the message you'd like on your nameplate in this box.

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.

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.