The following information is needed to schedule an appointment with our clinic. Please answer as much as pertains to you.
Last Name:
First Name:
Street Address
City:
State
Zip:
County:
Phone No:
Email:
Description of animal:
Animal's name:
Is your animal a dog or cat?
Dog
Cat
Multiple animals
Is your animal a male or female?
Male
Female
Unsure
Approximate age?
If a cat, do you have a medical assistance Forward or Quest card?
Yes
No
Unsure
Do you have a military ID?
Yes
No
If a dog, what is an approximate weight of your dog?
What breed or breeds is your animal?
What is the color or colors of your animal?
Services other than spay or neuter are only available the day of the appointment.
Would you like your animal to receive a rabies vaccination? An animal must be 12 weeks old to receive a Rabies vaccination. (Free for dogs, $10 for cats)?
Yes
No
Unsure
A Bordatella vaccination ($5, dogs only)?
Yes
No
Unsure
A heartworm test ($10, dogs only)?
Yes
No
Unsure
A Distemper vaccination ($5 for dogs and cats)?
Yes
No
Unsure
A microchip implantation, including registration ($20)?
Yes
No
Unsure
Feline leukemia/FIV test ($15-$20, cats only)?
Feline leukemia
Both
No
All animals having surgery are given an injectable pain medication that lasts about 24 hours. Take home pain medication is available for purchase. A three day supply is between $10-$15 depending on weight. Would you like to add that on for your animal?
Yes
No
Unsure
An eartipping (free removal of the left ear tip, done to identify outdoor/free roaming cats as sterilized and vaccinated)?
Yes
No
Unsure
Click here for more information on ear tipping.
Are there any medical problems or pregnancies this animal has now or has previously had that we should be aware of?
Where does this animal spend most of its time during the day?
Inside house
Outside of house
Inside and outside of house
Other
Appointment Preference
Drop off is 7-7:45 AM and pick up is 5-6 PM the same day.
L
ate
drop offs and early pick ups are not allowed. In order to keep costs low we are minimally staffed and only admit and discharge patients during the specified times.
Surgeries are performed Monday through Thursday and the first and third Saturday per month. Please list if you want the first available appointment, if any day is fine, or pick a specific date on the calendar below.
Appointment preference:
Second choice:
How should I care for my animal after surgery?
To learn more about our clinic, click here.
Do you have additional comments or questions?
How did you hear about our services?