Ervets4pets.com - WCAS /Control Form

Wake County Animal Shelter/Control Form
Animal ID Number:*
Species:*
Other
Age:*
Color:*
Sex:*

MaleFemaleUnknown
Reason for Visit:*
Animal Control Officer Name:*

First NameLast Name
I acknowledge that Wake County Animal Control has taken ownership of this animal prior to admittance to Animal Emergency Hospital and Urgent Care.
Signature*

Clear
Date

MonthDayYear
Date
I authorize humane euthanasia of this animal if deemed necessary by Animal Emergency Hospital and Urgent Care and Wake County Animal Control.
Signature*

Clear
Date

MonthDayYear
Date
Should be Empty:

Wake County Animal Shelter/Control Form