Name* First Last Email* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Phone*Relationship to the Pet* Pet's Name* Authorization I Agree By checking the above box, I hereby request and authorize Hindman Funeral Homes & Crematory, Inc. and affiliates (Hindman) to transfer the deceased pet into their care. I represent that I am the legal owner of the deceased pet or have the authority in matters pertaining to the disposition of the deceased pet and have selected cremation. I acknowledge that charges apply from the initial transfer of the deceased pet into Hindman’s care and agree to pay the flat fee of $350 for the individual cremation which also includes the transportation and basic pawprint urn. I acknowledge that after hours or weekend rates could apply. CAPTCHA Δ
