Welcome to the Family!

To ensure the best care possible, please take a moment to complete the following information.
Thank you for giving us the opportunity to care for your pet(s)!

Registration

Owner's Name(Required)
Spouse/Co-Owner's Name
Address
Are you currently Military or a First Responder?
How did you hear about us?

Pet

Species
Would you like to add another pet?

Second Pet

Species

Authorization

I hereby authorize Animal Health Care Center to examine, prescribe for and treat the pet(s) listed above. I assume responsibility for all charges incurred in the care of the animal(s). I also understand that these charages will be paid at the time of release and that a deposit may be required for treatment.

Signature of Owner or Responsible Party
  • Your Name
  • Your Name
  • Your Name