The following information is needed to request 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(s):
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 with surgery)
Yes
No
Unsure
A $10 Bordetella vaccination? (dogs only)
Yes
No
Unsure
A $20 heartworm test? (dogs only)
Yes
No
Unsure
A Distemper vaccination? ($5 for grant funded cats, free for dogs and cats with paid surgery)
Yes
No
Unsure
A $20 microchip implantation? (includes registration)
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 $15 for dogs or cats. Would you like to add that on for your animal?
Yes
No
Unsure
An eartipping? (surgical removal of the left ear tip, to identify outdoor/free roaming cats as sterilized and vaccinated. Non-grant funded cat surgeries will receive a $5 discount for ear-tipping)
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 typically 5-6 PM the same day.
L
ate
drop offs and early pick-ups are not allowed. We are closed on Friday and Sunday. Please list if you want the first available appointment, if any day is fine, or pick specific dates on the calendars below.
Appointment preference:
Second choice:
To learn more about our clinic, click here.
Click here for instructions on surgical aftercare
Do you have additional comments or questions?
Please tell us how you heard about our services.