Quality of Life / Hospice / End-of-Life Visit Questionnaire

Thank you for trusting us during this deeply meaningful time. Our goal is to support both your pet and your family with comfort, clarity, and peace. This form helps us prepare thoughtfully for your visit.

Client Contact Information

Pet Information

(This helps us guide the pace and emotional environment of the visit.)

Memorial Authorization

Preparing Your Home for a Peaceful Visit

To help create the most calm and meaningful experience possible, many families find comfort in:

• Choosing a quiet, comfortable location where your pet feels safe

• Using soft bedding or a favorite blanket

• Playing gentle music or maintaining a peaceful silence

• Allowing time for goodbyes and reflection

• Dimming lights or opening curtains for natural light

• Having treats, photos, or meaningful objects nearby

• Deciding in advance who will be present

• Preparing other pets for possible emotional reactions

There is no “right” way — only what feels most loving for your family.