Thank you for visiting Airport Animal Emergi-Center.
If you have not already spoken with staff prior to visiting this registration form please contact us at (317) 248-0832 for additional check-in information and our current wait time.

If you are unable to complete this form or have any difficulties, please contact our staff at (317) 248-0832.

Client Details


Yes
No

Secondary Contact

Patient Details


Canine
Feline
Other

Male
Female
Unknown

Yes
No
Unknown


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No


  • Critical and unstable patients will be seen first, followed by the order presenting to the hospital.
  • Airport Animal Emergi-Center opens at 6PM Monday through Friday, closing at 8AM on weekdays. AAEC remains staffed and open 24 hours during weekends and holidays.
  • The examination charge is $139 and all diagnostic testing, treatments and medications are additional and all fees are due at time of service. Airport Animal Emergi-Center is able to accept CareCredit or Scratchpay. We are unable to bill or establish payment plans.
  • I hereby authorize doctors and staff to administer treatment as therapeutically and/or diagnostically necessary on the basis of findings during the course of the evaluation. I consent to the use of treatments, medications, anesthetics as are necessary of an emergency nature. I assume full financial responsibility for all charges incurred by the patient, the release of medical information, and authorize direct payment to Airport Animal Emergi-Center, PC. I agree to pay all reasonable and customary fees, administrative fees, and court costs for any unpaid balanced.

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