Pre-Register

Please use the form below to pre-register you and your pet for care at Charleston Veterinary Referral Center.  You may use this form prior to a visit with one of our specialsits, or to pre-register to streamline the process should your pet have an emergency and come to CVRC.  If your pet is currently having an emergency, or might be having an emergency, please contact us at (843) 614-8387.

Contact Information

Emergency Contact Information

If we are unable to reach you, who may we contact in case of emergency?
Pet Information
Primary Veterinarian Information
Additional Information
1 + 13 =
Solve this simple math problem and enter the result. E.g. for 1+3, enter 4.