Staff Pet Appointment Request Form

HSTC staff members are required to fill out an online staff request form for each pet that they want to be seen by our veterinarian. Please make sure that your pet is set up in Pet Point prior to filling out the form as we will need an Animal ID# to be assigned in advance. All appointments are on a first come, first serve basis and are at the discretion of the veterinarian on staff. HSTC has the right to pause the Staff Pet Program at any point in time if our in house inventory becomes full and/or if we have a contagious outbreak and it is deemed unsafe for staff pets to be seen. 
Please make sure you have a Staff Animal Policies form signed and on file. Each staff member should only sign this form once. CLICK HERE to access the form.


Staff First Name
Staff Last Name
Primary Phone
Alternate Phone
Pet Name
Animal ID Number
Reason for Exam
Date Requested (preferably on day off, unless approved)
By checking this box, I agree to the terms below
As the owner of the above referenced pet, I hereby authorize the veterinary staff of the Humane Society of the Treasure Coast, Inc. to examine my pet and provide any necessary services. I recognize that HSTC may not act as my primary veterinarian, and that illness or emergency care should be provided by a primary veterinarian office.
I agree that by typing my name below, this serves as a legally binding substitute for a handwritten signature