Microchip Registration Form

A microchip implant is an identifying integrated circuit placed under the skin of a pet. It emits a radio frequency signal that transmits data to a special handheld device. After verifying that your pet does not already have a chip, we will record the microchip's unique identification code and inject the chip using a sterile syringe, just under the skin between the shoulder blades. If you are planning on having your pet microchipped, please complete the form. The registration will be finalized at the time of the microchip implant.
  • Owner Information

  • Pet Information

  • Date Format: MM slash DD slash YYYY
  • Medical Information

  • In the event you don't have the Rabies date, we will review our records and put in the date and Rabies Tag # for you.
    Date Format: MM slash DD slash YYYY
  • Alternate Contact or Breeder