South Shore Veterinary Care
Quarantine Liaison Service Information Request Form

Use this form to tell us about you and your pet. We will respond as soon as possible to provide you with an idea of what you can expect to face throughout the quarantine process. Our Quarantine Liaison specialist, Karen Hannie can make the experience as painless as possible to make sure you and your pet spend little or no time apart when you arrive in Hawai'i.

* Required Fields

Your Name*:
Your E-mail*:  
Your Phone Number:
FAX:
Your Address:
City:
State:  
Zip Code:
Your Pet is a:
Your Pet's Name:
Your Pet's Breed:
Your Pet's Age and Sex:
Your Current Vet:
Vet's Address:
City:
State:  
Zip Code:
Vet's Phone Number:
When do you plan to bring your pet to Maui?*

Special requests or comments:
How did you hear about us?