Clinic seeking Veterinarian Locum Form
The information you provide below will be published on our Clinic Locum Map on the MVMA Website
Clinic Name
*
Clinic Address
*
Street Address
Street Address Line 2
City
Province
Postal Code
Clinic Contact Person
*
First Name
Last Name
Contact Email Address
*
example@example.com
Contact Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Clinic Website Address
Please include a brief description of your practice
*
Are there accommodations available?
*
Yes
No
Professional Liability Insurance:
*
The clinic will provide professional liability insurance to locums
The clinic does NOT provide professional liability insurance to locums
Professional liability insurance will be decided on a case by case basis
Number of Veterinarians in the practice
*
Type of practice (check all that apply):
*
Large Animal
Small Animal
Equine
Other
If other selected above, please indicate:
Please describe locum information below (i.e.: period of time, frequency etc.)
*
Submit
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