Briarwood Animal Clinic

1621 W 86th St
Indianapolis, IN 46260

(317)872-4326

www.briarwoodanimalclinic.com

Vaccination Status Report Request

Need vaccine records for a current patient sent to a trainer, groomer or boarding facility? Fill this form out as best as you can and we will send a vaccination certificate directly to the facility for you! Or you may leave the non-required fields blank and we will send the records directly to you.

Vaccine Request Form

Name (required)

First Name (required)	Last Name (required)

Pet(s) Name (required)

Client Phone
Phone Type	Phone Number

Client E-Mail Address :

Name of facility to receive records

Facility phone

Facility fax

By selecting this check box you are agreeing to allow us to share records to the requested facility.

I agree

Verify the reCAPTCHA:

COVID-19 Update

During these uncertain times, please call before coming over as our hours are fluid and may change from week to week.

Mon		8:30am-7pm
Tue-Fri		8:30am-5pm
Sat		8:30am-12pm
Sun		CLOSED

Briarwood Animal Clinic
1621 W 86th St
Indianapolis, IN 46260

Phone: 317.872.4326
Fax: 317.876.3466