Vet Hospital Application Roster

2. <strong>Pierce County Animal Control</strong><br> Parkland-Spanaway Precinct<br> 14113 Pacific Ave S, Parkland, WA 98444<br> (253) 798-7427</br>

   Pierce County Animal Control
   Parkland-Spanaway Precinct
   14113 Pacific Ave S, Parkland, WA 98444
   (253) 798-7427
   

6. Clinic Name*

8. Clinic Address*

9. City*

10. Zip*

12. Phone*

13. Email*

14. Fax

16. Clinic Hours*

20. Medical Director*

21. Hospital Administration/Manager*

23. Number of Veterinarians on Staff*

24. Number of Vet Technicians on Staff*

28. What Services are Offered*

30. Capacity for Dogs*

31. Capacity for Cats*

33. Do you see or handle any other animals besides dogs and cats?*

    1. Yes
    2. No

34. Do you have policies in place for aggressive or fractious animals?*

    1. Yes
    2. No

36. What other animals will you see?*

37. Please Describe*

39. If medical attention is needed for an animal, can you hold the animal over a weekend to monitor the animal until a vet at the Humane Society is available to take over care?

    1. Yes
    2. No

43. Electronic Signature*

    Please type your first and last name

44. Date*
    Date

45. Terms of Acceptance*

    1. I understand that checking this box constitutes a legal signature. I certify under penalty of perjury, under the laws of the State of Washington, that the foregoing information is true and correct (RC

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47. 1. Receive an email copy of this form.
48. Email address

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49. Submit

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