Tri-County Animal Emergency Clinic

Veterinarian Referrals

If you are a Veterinary Office referring a client to our clinic, please click the button below to fill out our transfer form.

Online Transfer Form

Intake Form

Please fill out the intake form before arriving at the clinic to help us prepare for your pet’s care.
Providing this information in advance allows our team to assess the situation more efficiently and better prepare for your pet's arrival. Submission of this form does not hold a spot in line. Order of patient care is based off severity of each case not upon order of arrival. Thank you for your understanding.

First Name *

Last Name *

Phone *

Email *

Address ( City, State, Zipcode ) *

Pet Information

Veterinary Clinic Name *

Pet Name *

Species *

Breed

Age *

Gender / Sex *

Pet Medical History

Spayed/Neutered

Yes No

History of Seizures?

Yes No

Known Heart Condition?

Yes No

Please list any known health conditions for your pet

Describe your pet's symptoms

Submit