Herp Vet Connection

Vet Recommendation Modification Form

Please only use this form to add comments to a currently listed vet or to update a currently listed vet's information.

Submitter's Information

Please provide accurate information in order for HVC to contact you or if visitors wish to inquire in more detail with regards to the vet in question. Unless the fields have been marked private, information will be displayed. In the case of the name, only the initials would be used. In the case of email, it will be not be displayed but linked to the submittor's initials or to an non-private field.
E-mail Address:   required
Name:   required
City:
State:
Province:   Country:
Mark above fields to be kept private
Email    City    State    Province    Country
In order for visitors to further inquire regarding the vet you recommended, may we link your email address? Your email address will be linked only if the above Email field has NOT been marked private and email linkage has been approved below.
Yes    No

How did you learn of HVC?

Feedback to HVC?

Veterinarian's Information

The Vet Name and State Currently Listed Under fields must be completed so we can locate the vet's record.
Please complete only the fields that require updates.
If you only have to add comments, simply complete the Vet Name, State Currently Listed Under and the Comments fields.
Vet Name: required
State/Province Currently Listed Under: required
Practice Name:
Address:
Address:
City:
State:
Zip:
Province:   Country:
Phone:     Phone:
Fax:
Emergency:
Pager:
Email:
Website:
Additional Information:

Comments:   Please indicate herp examined, experiences with vet, etc.

The submitted information will be reviewed and verified prior to display on the relevant vet listing page.

Do you have comments or require assistance? Please note that we are not veterinarians.
Please contact the HVC Team and one of us will respond as soon as possible. If this is an emergency, please contact your nearest qualified veterinarian.

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All gathered data/text, images/graphics and code, unless stated otherwise are property of Herp Vet Connection and cannot be used without written permission from the HVC Team.
Herp Vet Connection is developed and owned by Susan Julian,Joan Appell,& Desiree Wong.
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