Donation Consent Form

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City University of Hong Kong
Jockey Club College of Veterinary Medicine and Life Sciences
Little Angel Educational Memorial Programme
Donation Consent Form
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Part A

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Part B

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Part C, D & E

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Part A: Pet's Details

(Only mammals are currently accepted e.g. dog, cat, rabbit, guinea pig etc.)
(Select appropriate)
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Part B: Donor's Details

I hereby agree the below statements:

I would like to have the ash of my animal returned.
(Select appropriate)
I would like to have a farewell ceremony, at my expense, at the JCC DESIGNATED ANIMAL CREMATION COMPANY.
(Select appropriate)
The designated animal cremation company (Goodbye Dear) has been carefully chosen by our team to ensure professional handling, and to manage health and safety concerns. Please kindly understand the designated animal cremation company cannot be changed.
Should a farewell ceremony be wished, a staff from Goodbye Dear will contact you shortly for further details and arrangement.
JCC is not responsible for the farewell ceremony and associated arrangement
If a farewell ceremony at Goodbye Dear is not wished, please farewell your animal at the clinic at the time of filling in this consent form. You will not be able to farewell your pet after its body has been transferred to our college for teaching.
Should ashes return be wished, a staff from Goodbye Dear will contact you for ashes pick up when ready.
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Part C: Veterinarian's Details

Part D: Recognition on the virtual Memorial Wall
Thank you for your support of the Little Angel Educational Memorial Programme. Would you like to honour your pet by adding their name to our virtual Memorial Wall on the programme website?
Part E: Signature
Consent forms will be held securely by the City University of Hong Kong for 10 years in compliance with the university regulations for data protection.
Personal information collected are for the Little Angel Educational Memorial Programme solely and will not be disclosed to anyone beyond this programme.
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Part A

Part A: Pet's Details

Part B

Part B: Donor's Details

Part C, D & E

Part C: Veterinarian's Details

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