E&D

We are so sorry you are having to make this decision today and want to be here to help you through this process. These questions will help us to get you fully pre-registered and make the process easier for you and your pet.

YOUR PET'S INFORMATION

Has your pet been here before or is this their first visit?(Required)

What is your pet's name?(Required)

How old is your pet or what is their date of birth?(Required)

Is your pet male or female?(Required)

Has your pet been spayed or neutered?(Required)

What species is your pet? Cat? Dog? Something else?(Required)

What breed is your pet? (If your pet is a cat, does it have short, medium or long hair?)(Required)

What color is your pet?(Required)

YOUR INFORMATION

Have you been here before or is this your first visit?(Required)

What is your last name?(Required)

What is your first name?(Required)

What is your street address (not PO box)?(Required)

What is your city, state and zip code?(Required)

What is your e-mail? (We can't send or receive from icloud.)(Required)

What is your phone number? (You can give us more than one, but a mobile phone is preferable.)(Required)

Does your pet have any co-owners (spouse or others)?(Required)

Who is your primary veterinarian? (Please give us the name of the clinic rather than the doctor.)(Required)

What led you to come to this decision?(Required)

Please choose one of the following for aftercare.

Should we know anything about your pet's visit today? Are they anxious? Aggressive? Prone to flee?(Required)

How did you hear about us?(Required)

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700 W STATE ST

(716) 257-4830

7 Days a Week

E&D

YOUR PET'S INFORMATION

YOUR INFORMATION

Text Now (716) 257-4830