American Vet - Pet Relocation - Client Registration Form

American Veterinary Clinic

Al Falah Street
Abu Dhabi - UAE, BC PO BOX 31051

(971)665-5044

www.americanvet.ae

Pet Relocation - Client Registration

This won't take long...

If an AVC Pet Relocation Advisor asked you to fill out an online registration form - this is it.

Pet Relocation - New Client Form

Name + Email (required)

First Name (required)	Last Name (required)

E-Mail Address :

Phone (required)
Phone Type	Phone Number (required)

Address
Street Address

City ,	State / Province	Zip / Postal Code

Pet's Name:

Species:

dog
cat
bird
other

Breed:

Pet's Date of Birth (mm/dd/yy)

Sex:

male
female
I'm not sure

Is your pet sterilized? (neutered for males / spayed for females)

yes
no
I'm not sure

Description / Color

Is your pet microchipped?

yes
no
I'm not sure

Microchip Number

Date of Microchipping (mm/dd/yy)

Departing From (city / country)

Arriving In (city / country)

Additional Questions or Comments

PLEASE READ:
By submitting this form I authorize the American Veterinary Clinic (AVC) to arrange for the transport of my pet(s). I understand that the AVC will provide the best possible care for my pet(s) during transport. I understand the inherent risks associated with transport and agree that the AVC, its employees and representatives will not be held responsible for any loss, injury, or loss of life to my pet(s) during transport. I agree to exempt the AVC, its employees and representatives from any liability or legal proceedings arising from such transport. I also understand that insurance for traveling pets is not available through the AVC.

I have read the above statement and agree to the terms outlined. (required)

Agree

Verify the reCAPTCHA:

American Veterinary Clinic

tel: 00971 2 6655044

emergency: 050 6151711

Opening Hours:

Sunday 9:00 am - 5:00 pm

Monday 9:00 am - 5:00 pm

Tuesday 9:00 am - 5:00 pm

Wednesday 9:00 am - 5:00 pm

Thursday 9:00 am - 5:00 pm

Friday 9:00 am - 5:00 pm

Saturday Closed

Brought to you by eVetSites®
Inspired by the VIN community, part of the VIN family