KBVE Application for Veterinary Facility Registration Kentucky Board of Veterinary Examiners


7. Identify mobile units* affiliated with the facility:


Mobile Unit License Plate (State – Plate #)


Vehicle Make & Model


Primary parking address, if different from page 1


Counties served


Primary species served


Application for Veterinary Facility Registration


*Attach additional pages as necessary.


8. Indicate if the veterinary facility or any facility employee holds one (1) or more of the following permits from the Kentucky Department of Fish and Wildlife Resources (KDFWR). KDFWR


Regulatory Citation Permit Name 301 KAR 2:075


301 KAR 3:120 301 KAR 2:081 301 KAR 2:082


Permit Number Certified Wildlife Rehabilitator


Commercial Nuisance Wildlife Control Operator


Captive Wildlife Holder Wildlife Transporter


VI. Application Check List


 Acknowledgement regarding requirement to post veterinary facility registration on the premises of each registered fixed facility and mobile unit.


 Application fee – Payable to the Kentucky State Treasurer. Fees pursuant to 201 KAR 16:515. Checks may be personal, business, cashier’s check, or money order. Do not send cash. Mail to KBVE.


 On or before June 30, 2025,  $100 for initial registrationfor a fixed facility and up to two (2) mobile units; or  $100 for initial registrationfor three (3) mobile units without a fixed facility; and  $25 for each additional mobile unit, total additional units = ______ x $25 = _________.


 After June 30, 2025, initial registration fees:  $500 fixed facility and up to two (2) mobile units; or  $500 three (3) mobile units without a fixed facility; and  $25 for each additional mobile unit, total additional units = ______ x $25 = _________.


Submit Complete Application to: Kentucky Board of Veterinary Examiners 4047 Iron Works Parkway, Suite 104


Lexington, Kentucky 40511 KVMA News | Spring 2025 Page 5 of 6


Form Last Updated: 2/2025 MIR: 201 KAR 16:762


43


Expiration Date


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