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Printable Patient Registration Form

AV Veterinary Center

1055 W. Columbia Way #103, Lancaster, CA 93534 · (661) 729-1500

Print this form, complete it at home, and bring it with you. Completing registration online is the fastest way to get your pet registered before your visit.

Owner information

Home address

Authorized decision maker

Pet 1

Species

DogCat

Sex

FemaleMaleUnknown

Microchip

YesNo

Pet 2

Species

DogCat

Sex

FemaleMaleUnknown

Microchip

YesNo

Signature