Clinic enrollment

Please share as much accurate infomation as you can. State Law makes it Manditory that we have a waiver that w share with you for your pet

First Name *
Last Name *
Phone Number *
Email *
Address *
Town *
State *
Animal Name * Please type none if stray or has no name
Gender *
Species *
Breed *
Estimate birthday *
Size *
Description *
Fixed *
Waiver : I as the owner I understand that this is a clinical environment with a medical procedure that has risks and do not hold FCAR liable * I as the owner I understand that this is a clinical environment with a medical procedure that has risks
Animal Picture * Please Share pictures if possible. You have pictures of your animal in their normal happy state which can help us share how wonderful they are.
I am the Owner *

Submitting this form is the start of a clinic appointment process. The ownership of the animal and responsibility of the animal is still with the owner. Due to the shelter environment submitting this form will only be part 1. Part 2 will the appointment and the owner will be responsible for any registration/after care