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Arizona State Veterinary Medical Examining Board
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Forms

Veterinarians - Pathways to Licensure

AttachmentSize
PDF icon Veterinary Regular License Application Packet533.8 KB
PDF icon Veterinary Endorsement License Application Packet421.4 KB
PDF icon Licensure via Universal Recognition Application Packet496.89 KB
PDF icon Veterinary Specialty License Application Packet570.98 KB
PDF icon Veterinary Faculty License Application Packet689.77 KB
PDF icon Veterinary State Employee Application Packet450.99 KB
PDF icon 2020 Veterinary State Exam Dates & Application Deadlines - THROUGH NOVEMBER 2020, THESE DATES ARE NOT APPLICABLE DUE TO COVID70.24 KB
PDF icon License Verification Request - Veterinarian - NO FEE DURING COVID STATE OF EMERGENCY156.59 KB
PDF icon Change of Address/Employment/Name99.73 KB
PDF icon Duplicate Wall License Request Form231.92 KB

Certified Veterinary Technicians (CVT)

AttachmentSize
PDF icon CVT Application Packet - DO NOT USE UNLESS YOU HAVE PASSED THE VTNE407.35 KB
PDF icon CVT Universal Recognition Certificate Application (for Arizona residents licensed/certified in another state)-COVID374.39 KB
PDF icon CVT Address/Employment/Name Change Form187.81 KB
PDF icon CVT Certificate Verification Request (aka "letter of good standing")106.09 KB
PDF icon CVT Duplicate Wall Certificate Request Form232.99 KB

Premises

AttachmentSize
PDF icon Premises License Application264.76 KB
PDF icon Premises Inspection Report (check-list)450.53 KB
PDF icon Notice of Inspection Rights147.43 KB
PDF icon Small Business Bill of Rights119.19 KB
PDF icon Anesthesia Log example26.33 KB
PDF icon Controlled Substance Dispensing/Administration Log example37.32 KB
PDF icon Controlled Substance Inventory Log example26.7 KB
PDF icon DEA Registered Reverse Distributor List - 2020254.77 KB
PDF icon Premises Name Change/ Change of Scope Request Form144.78 KB
PDF icon Duplicate Premises Wall License Request187.25 KB

Animal Crematories

AttachmentSize
PDF icon Animal Crematory Application & Instructions180.97 KB
PDF icon Animal Crematory Inspection Checklist111.04 KB
PDF icon Animal Crematory Name Change/Scope of Service Change Form69.09 KB

Complaints

AttachmentSize
PDF icon Complaint Investigation Form68.93 KB
PDF icon What to Expect After A Complaint is Filed134.4 KB
PDF icon FAQs: Complaints & Investigations44.21 KB

Miscellaneous

AttachmentSize
PDF icon Public Records Reproduction Request Form143.35 KB

Registered Equine Dental Practitioners

AttachmentSize
PDF icon Equine Dentistry Registration Form100.28 KB
PDF icon Equine Dentistry Supervisor Form72.43 KB
PDF icon List of Registered Equine Dental Practitioners28.4 KB

Unlicensed Practitioners

AttachmentSize
PDF icon Unlicensed person providing veterinary care: Mario J. Cruz - Consent Agreement & Order637.1 KB
PDF icon Mario J. Cruz - Cease & Desist Order - Practicing without a license121.14 KB
PDF icon Kara Keller - Impersonating a veterinarian966.88 KB
Arizona State Seal
Contact Us
Arizona State Veterinary Medical Examining Board
1740 W Adams St
Phoenix, AZ 85007
Find in Google Maps
Phone: (602) 364-1-PET (1738)
Fax: (602) 364-1039
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