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PLEASE NOTE: Forms are for office use only. Online forms are for clients with existing appointment scheduled.

Owner / Caregiver

Please provide the information below as completely as possible. All information is strictly confidential.

Pet Information

Referral Information

Statement Of Ownership

By checking below you certify that you are the owner and or agent of the above animal and have the authorization to consent to treatment if and when it is needed.

Acknowledgment and Consent

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Directions to our facility: The Maine Veterinary Medical Center, (formally the Maine Veterinary Referral Center), is located right off Route 1 in Scarborough, between Scarborough Downs and Haigis Parkway at 1500 Technology Way in the Enterprise Business Park. From North or South on I-95 (Maine Turnpike) take exit 42 off I-95; Continue straight through the intersection on Haigis Parkway.At the next four-way intersection (Route 1), turn left onto Route 1. From Route 1, look for Enterprise Business Park at the next light. Take a left into the business park and proceed onto Technology Way. We’re at the end, at the top of the cul-de-sac. For future emergencies, please enter this phone number in your home and cell phone, 207-885-1290.