Quality of Life Medical Form

We understand how difficult completing this form will be for you. Our hope is that it will allow us to be better prepared for the upcoming visit and ensure a smoother visit for you.

Thank-you for this information. To better prepare you for the upcoming visit, we want to share the following information.

Please bring anyone who wishes to say goodbye and be present for euthanasia to this visit. Masking is required for all, and anyone with symptoms of illness should NOT come this visit. We will do our best to accommodate all who wish to be present, but our space is sometimes limited by other services being provided.

The visit will begin with a complete physical examination and additional questions from our veterinarian. It is important that your pet’s primary caretaker be present or available via phone for these questions. This will lead to discussion of treatment options or how we can assist your pet cross the Rainbow Bridge. Not all treatment options are appropriate for all families, and we are not interested in pressuring you to choose treatment if euthanasia is also a reasonable choice. We simply wish to ensure you make an informed choice about a service we can not reverse.

If euthanasia is the best choice for your family, we will proceed to performing that service at this visit. Our veterinarian will describe the service from start to finish before beginning. You may take as long as you need to say goodbye before we begin and after the euthanasia is complete. We will have a variety of treats available for your pet if he or she wishes to eat.

Our team will guide you through the needed decision making and provide you with the costs associated with your options. We will complete all necessary paperwork and collect the fee before we proceed to the euthanasia.

You will be asked how you would like your pet’s aftercare handled. You can take your pet home for burial, but this is not an option many people feel comfortable doing. We can also offer cremation. If you would like your pet’s ashes returned to you, there is an additional cost for this private cremation. A company called Faithful Companions handles this for us. They are incredibly gentle and respectful and have been in business for many years, we fully trust them with our patients. Once Faithful Companions returns your pet’s ashes to us (about one week), our office will call to let you know so that you may come back and collect your angel. The fees associated with a private cremation include the service, a beautiful carved wooden urn box, a clay paw print created and painted by our team (you will be asked about your color preferences), a lock of your pet’s fur, and some information about how to further memorialize you pet.

Some people opt to further memorialize their pet by having glass jewelry or orbs created by artists who can infuse a small amount of your pet’s ashes into the piece. A company called Spirit Pieces offers this, but there are several available. If you wish to do something like this, we can assist you with transferring some of your pet’s ashes into the supplied mailer once you receive that from the company of your choice, if that would be too difficult for you. Keep in mind that this is something that would occur after this visit.

We encourage you to ask questions at any time through this process. We understand how difficult it is to lose a cherished family member, and we want you to be at peace with this decision. Our website has a page devoted entirely to Quality of Life, and we encourage you to visit if you have not already for several resources. www.lakeroadanimalhospital.com

Caring people who care for pets.


3065 Lake Rd
Horseheads, New York, 14845
Click here for directions.


Mon: 8:00 am – 6:00 pm
Tue: 8:00 am – 6:00 pm
Wed: 8:00 am – 6:00 pm
Thur: 8:00 am – 6:00 pm
Fri: 8:00 am – 6:00 pm
Sat: 8:00 am – 1:00 pm

Contact & Connect

Phone (call or text): 607-733-6503
Fax: 607-733-3656
Email: [email protected]

Directions from Corning:
  • Take 17/86 east towards Binghamton
  • Take Exit 53 (Horseheads) exit and stay to the right
  • Go through two lights, and at the third light take a right onto South Main, this turns in to Lake Road
  • The hospital is ~1.5 mile on the right
Directions from Elmira – local roads:
  • Take Church St. or Water St.to the Madison Ave Bridge
  • Take a left on to Madison Ave, this turns in to Lake St, and then to Lake Rd.
  • Follow Lake St. to Lake Rd. past Curly’s Chicken, the hospital is ~1/2 mile on the left
Directions from Elmira – highway:
  • Take 17/86 West towards Horseheads/Corning
  • Take Exit 54 towards Horseheads/Rt 13
  • Stay to the left to exit towards Horseheads
  • At the light, take a left on to South Main which turns in to Lake Road
  • The hospital is ~1.5 mile on the right