polandvet@yahoo.com 
Phone: 330-757-8868
6609 Clingan Rd.
Poland, OH 44154 
Copyright 2006 Poland Veterinary Centre 


Welcome to Our Site

Thank you for giving us the opportunity to care for your pet.  We'll be happy to answer any questions you have about your pet's health.  Please complete this form in order to expedite your initial visit to our office.

Before submitting this form, please review your information and enter your Online Signature to confirm that all of the entries are correct.


*Name
*Address
*Home Phone
Cell Phone
*Pet's Name
*Species
Breed
Age
*Vaccine Status
*Name of Previous Veterinarian
*Reason for Visit
*Would you like us to contact you to schedule an appointment?
*Online Signature (your name)
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