ANIC Client Registration

In order to help facilitate your check-in process, we offer our client registration form online (see below). Fill it out anytime prior to your appointment….just one less thing to worry about on your appointment day.

New Client Information
Note: This form is for registration at the Albuquerque, NM location ONLY.
Name*
First Last
Address*
Street Address Address Line 2 City State ZIP Code
Home Phone*
Cell Phone*
Email*
Employer
Occupation*
New Patient Information
Pet's Name*
Pet Species*
Pet Breed (If known)*
Approximate Age*
Spayed or Neutered?*
Approximate Weight (in pounds)*
Vaccination Status
Pet Vaccinations Current?
Date of Last Rabies Vaccine*
List any medications (& dosage) your pet is currently taking*
Current Veterinarian Information
Name of your current veterinarian
Name of Veterinary Clinic where your pet is normally seen
Address of Veterinarian
Street Address Address Line 2 City State ZIP Code
We normally fax/email your regular veterinarian updates on your pet's condition. Please select one of the following options:*
- YES. Please fax/email my regular veterinarian updates on my pet's condition.
- NO. I DO NOT want any of my pet's records from The ANIC fax/emailed to my regular veterinarian.
CAPTCHA
Email
This field is for validation purposes and should be left unchanged.

ANIC New Mexico has Moved!

We are very excited to announce that The Animal Neurology and Imaging Center of New Mexico has joined our partners at Veterinary Emergency and Specialty Center of Albuquerque (VESC).

As of January 3rd, we will be operating together at the current facilities of VESC Albuquerque:

4000 Montgomery Blvd NE
Albuquerque, NM 87109

By combining forces, we will have the necessary support to provide a continuum of care for your pets in need of emergency and routine neurological care.

For more information, please call us at 505-884-3433.

We are excited to unite as an even stronger emergency and specialty care team for you and your pets.

ANIC Client Registration

New Client Information

New Patient Information

Vaccination Status

Current Veterinarian Information

ANIC New Mexico has Moved!