Online Cremation Authorization Form

To make arrangements easier, we welcome you to fill out the following order form. We will then contact you to schedule a pickup or drop off time for your pet.

* Pet's Name:

* Pet Owner's Name:

Address:

* Email Address:

Phone No:

Veterinarian Office:

* Pet Weight:

* Date of Death:

Age:

* Please select an option:

Family will pick up cremains from veterinarian
Family will pick up from NPCS (Call prior to pick-up to ensure pet is ready)
Family Does Not want cremains returned

 

* Urn Selection

Paw Print Urn
Other – view our urn selection, select the ID number of the urn you want and place it in this field

I Hereby request and authorize Nansemond Pet Cremation Services to cremate the remains of my pet as listed above.


* Signature of Pet Owner:


 

To download a copy of the online ordering form click HERE