Registration Form

  • Pet Parent Information

  • Pet #1 Information

  • Pet #2 Information

  • Pet #3 Information


    I confirm I am 18 years old (or older) and I am the owner (or authorized agent of the owner) for the pet(s) listed above. With my signature, I authorize the veterinarians and staff of Edmonton West Animal Hospital & Spay/Neuter Centre to examine, treat, administer medications, and perform diagnostic and surgical procedures for my pet. I also agree to assume responsibility for all charges incurred in the care of my pet(s), as well as reasonable attorney’s fees, court costs, and interest if the balance is sent for collection. I understand that full payment is due at the time services are rendered.

  • This field is for validation purposes and should be left unchanged.