Pet memorial submission form

Thank you so much for honoring the love between your patients and their family with your gift to BirchBark. We appreciate your partnership in upholding the bond between people and their pets.

We will send a notification of your gift to your clients. Please ensure that addresses and client and pet names are spelled correctly. Thank you!

To submit more than one pet, please refresh the page after you submit the form.

You may submit your donation via mail (101 Cooper St., Santa Cruz, CA 95060), online, or through PetVet.

Hospital Name

Owner first name

Owner last name

Street address

City

State

You may leave blank if California

Zip code

Pet's name

Last name of vet on acknowledgment

You may leave blank if you'd like "All the staff" acknowledged.