Animal Care and Regulation
Home Find An Agency A to Z Guide
Complete the information below so that we can access your current record and update your information. In the space provided, type the old information listed on the rabies certificate. You must complete all these fields.
Email Address
First Name*
Last Name*
Street Address and Apartment No.*
City*
State* Zip*
Phone Number *
ex 954 1234567

Place a check(s) by the category(ies) to update or correct and provide the new information in the space below.
New Address
Street Address and Apartment No.
City
State Zip
Phone Number
ex 954 1234567
Alternative Phone Number
Email Address

Pet #1
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:
     
Pet #2
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:
Pet #3
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:
     
Pet #4
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:
Pet #5
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:

     
Pet #6
Pet Deceased
Pet's Name
Breed
Color
License Tag Number
Pet Given Away
Pet's Name
Breed
Color
License Tag Number
New Owner's First Name
New Owner's Last Name
Pet Information (Enter the pet's correct information for the rabies certificate below.)
Pet's Name
Breed
Color
Sex Male Female
Miscellaneous:

 

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