Externship Form | Quakertown Veterinary Clinic

Externship Form

Extern Confirmation and Consent Form

First Name
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Last Name
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Address
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Phone
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Email
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School
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Graduation Date
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Interest
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Living Arrangements
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Does your school cover you for liability while doing externships?
Please make a selection.

Externs will not be eligible to receive workmen's compensation in the event of a work-related injury that may occur while externing at QVC.

All externs are required to provide adequate health insurance for themselves in case of an injury that may occur during their externship at QVC. Please provide proof of health insurance that identifies your carrier and the expiration date of your policy. Enclose a photocopy of any document or card providing this information for our records.

If your school cover's your liability while doing externships, please send proof of coverage.

- I have read and understand the above information
  Please check box if you acknowledge information above
Full Name
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Date
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Caring for Your Whole Family.

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Advanced Technology
Quakertown Veterinary Clinic is proud to offer state-of-the-art technology to provide your pet with the highest level of care and diagnostic services.
Caring for All Types of Animals
At Quakertown Veterinary Clinic we are proud to serve all your animals' needs, whether you have a sick horse or a hurt cat, we are ready to care for them.
Open 24/7
We know that an emergency can happen at any time and that is why we offer 24-hour emergency care for dogs, cats, horses, farm animals & exotic pets.

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