AquaVets Registration Form

A Registry for Aquatic Animal Veterinarians engaged in any areas of aquatic animal health and medicine

Veterinarians should enter information as comprehensively as possible and how you would like it to be viewed by others

Once information is accepted, registrants will be notified by email.
A User Name and password provided by the database administrators will allow Registrants secured access to their information for editing at any time.
 
Contact Details
Title (Dr.,Prof.,etc)
First Name *
Middle (Other) Names
Last Name *
Business / Institution name
Address 1 *
Address 2
Address 3
Town/City *
County
State (US only)
Zip/Postal Code *
Country *
Phone 1 *
Phone 2
EMail *
Website URL
Veterinary Credentials
Primary Veterinary Degree *
If other, please specify
Univ./Coll./School *
Country *
Year of graduation *
Other Degrees
Where are you licensed to practise veterinary medicine ?
Please specify State/Province or Country
Are you an accredited veterinarian ? USDA-APHIS(US) or CFIA (Canada)
If Accredited in another country please specify (below) the accrediting federal agency and Country
Aquatic Vet related Associated membership
Check all that apply
AVMA CVMA
USAHA AAVLD
EAVA CAAV
AAVBC IAAAM
ISAAE EAFP
JSFP AmerFS-FHS
AsianFS-FHS Other
If other, please specify
Areas of aquatic animal health and medicine you are currently engaged in
Check all that apply, but at least one *
Private Clinical Veterinary Medical Practice
Diagnostic Laboratory Services
Health management/advisory/consulting services
Non Profit Organisation
Corporate (non-veterinary practice e.g. Research & Development, Marketing
Academic (University/College) Administration
Academic (University/College) Education (undergrad or grad)
Continuing Veterinary Education (Program development or Instruction)
Public/Industry Education (Extension)
Scientific Research (Academic, Corporate, Non-profit or Gvmnt.)
Government agency (local, state/provincial or federal)
check only if a Government official and involved with regulating aquatic animal health, seafood safety or other areas important to aquatic veterinarians
Other
If other, please specify
Species or Services Type you are currently involved with
Check all that apply, but at least one *
Commercial Aquaculture Wild Aquatic Animals
Food (fin) Fish Sport or Game Finfish
Baitfish Crustacean Shellfish
Molluscan Shellfish Ornamental Aquatic Animals
Amphibians Reptiles
Marine Mammals Seafood Safety
Other
If other, please specify
Comments
Please use this box to add any additional information about yourself or your practice, organisation or business that specifically deals with aquatic veterinary medicine and is useful for aquavets end users. The comments that you enter here may be edited by administrators for brevity, clarity or consistency before it becomes public.
Personal Preferences
I give permission for my details...
...to be displayed on this web site, and searchable by end-users
..to be displayed in possible future Directories of Aquatic Veterinarians and Diagnostic Laboratories


If neither box is checked, data entered into the database will only be accessible to the database administrators and you (the subscriber) through a secure User ID and Password.
 
Newsletters & Subscriptions

AquaVetMed is an email news service, administered and moderated by the American Veterinary Medical Association, that provides information to aquatic veterinarians registered in AquaVets
Check this box if you want to subscribe to AquaVetMed.
 
Before continuing you must confirm that you have read the Terms of Use relating to this web site.
The Terms of use can be read here.
Tick this box if you have read and agree to the terms and conditions.