Cremation Form

Name*
First Last
Pet's Name*
Phone*
Email*
Mailing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Species*
Breed*
Color(s)*
Weight*
AVHS # (If applicable)
Please select the type of cremation*
If unsure, please call 719-395-2737
- Extra Small Pet (0-2lbs) ($45)
- Small Pet (3-15lbs) ($95)
- Medium Pet (16-35lbs) ($125)
- Medium Pet (36-50lb) ($155)
- Large Pet (51-75lbs) ($175)
- Large Pet (76-100lbs) ($195)
- Extra Large Pet (101+ lb) ($225)
Please Check all additional services that you would like for this Cremation.
- Memorial Glass Leaf - Green ($50)
- Memorial Glass Leaf- Yellow ($75)
- Memorial Glass Leaf- Orange/Red ($100)
- Memorial Brick ($250)
- Private Cremation (additional $150)
- Mail Cremains to Owner (additional $40)
- No Ashes Back ($20 discount)
- Ashes back, no urn ($15 discount)
- Ink Pawprint + Frame ($40)
If you chose a glass leaf, when ready would you like it to be:
- Mailed to you
- Picked up at AVHS
- Hang it on the AVHS Memorial Tree
Any other notes
Pet has replacement hip or pins*
- Yes
- No
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