Microchip

Please provide as much detail as possible when filling out this form. Once information has been entered, you will be notified via email. If you have any questions, please call 812-349-3492.

First name *
Last Name *
Email *
Address *
City *
Zipcode *
Phone number *
Alternate phone number
Your pet's name *
Species *
Animal's Gender *
Please note your pets main breed(s) *
Please describe what your pet looks like:
Please enter pet's date of birth (ok to estimate if you do not know exact date): *
Pets Color *
Microchip number *
Did you register your pet with the microchip company? *
Has your pet been spayed or neutered?
Please provide your pets current rabies vaccination tag number
Name of Veterinarian who vaccinated your pet
Rabies expiration date
Animal Type for database entry: Office use only

Microchip

Register your Pet with Animal Control