REGISTER YOUR PET!

Email*

Welcome to Halifax Veterinary Centre. Your co-operation in supplying these details will help us to maintain full records of your pet’s health.

Your name*

Prefix First Last

Phone 1*

Phone 2

Address*

Street Address City ZIP / Postal Code Country

How did you hear about Halifax Vet?*

Google/other search engine
Social media
Yellow Pages
Recommendation
Radio
Referral from your own vet
Other

If you heard about us from an existing client please provide details so that we may thank them.

Pet name

This is the exciting part! Tell us all about your babies, we can’t wait to meet them. If you run out of space let us know and we can add the others for you – we don’t want anyone to miss out!

Species

Cat
Dog
Rabbit
Guinea Pig
Reptile
Bird
Other

Breed

Colour

Sex

Female Neutered
Male Neutered
Female Entire
Male Entire

Date of birth

Microchip number

Pet name (additional)

In no particular order, of course!

Species

Cat
Dog
Rabbit
Guinea Pig
Reptile
Bird
Other

Breed

Colour

Sex

Female Neutered
Male Neutered
Female Entire
Male Entire

Date of birth

Microchip number

Pet name (additional)

In no particular order, of course!

Species

Cat
Dog
Rabbit
Guinea Pig
Reptile
Bird
Other

Breed

Colour

Sex

Female Neutered
Male Neutered
Female Entire
Male Entire

Date of birth

Microchip number

Your previous veterinary health provider

Previous vet contact details

Phone number or email

Do you authorise us to contact your previous vet to obtain medical records for your pet?

Yes
No

Anything else? Please let us know if there is any additional information you'd like us to have regarding your pets or if you have a specific question. Thank you!

REGISTER YOUR PET!

Register now!

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