Spay Today PO Box 340 Charles Town, WV 25414 Hillside Veterinary Hospital 191 Augustine Ave Charles Town, WV **You pay Spay Today at the time of setting an appointment; this may be done by mail, in person, or over the phone with a credit card. We are not able to take payment over the internet. Administration fee: (required with each payment) ……………………..…………..$5 (Please circle procedure(s) requesting) Cats: must be 5 mo + Female Spay Rabies required Feline Distemper (each) $93.10 $17.50 $16.80 Dogs: must be 5 mo + Female Spay (under 20 lbs) Female Spay (21 – 50 lbs) Female Spay (51 - 80 lbs) Female Spay (81 – 100 lbs) Female Spay (101 lbs +) Rabies required Bordetella Lyme Required Information: $128.10 $135.80 $144.90 $152.60 $196.70 $17.50 $16.80 $21.70 Male Neuter Combo Test Feline Leukemia Vaccination (each) $55.30 $35.00 $16.80 Male Neuter (under 20 lbs) Male Neuter (21 – 50 lbs) Male Neuter (51 - 80 lbs) Male Neuter (81 – 100 lbs) Male Neuter (101 lbs +) Distemper (each) $97.30 $105.00 $113.40 $129.50 $154.70 $16.80 $31.50 Heartworm/Lyme/Ehrlichia Test Name: ____________________________________________ Address: _______________________________________________________________ _______________________________________________________________________ Home Phone: _______________________ Work Phone: ______________________ Required Pet Information: Name: _________________________________ Age: ______________________________ Breed (Dog): ____________________________ Color: ______________________________ Breed (Cat) Hair Length (Circle one): Short - Medium – Long Weight (Dog only):____________ My pet is up-to-date on rabies (Must provide certificate at drop off). Payment information: Make payable to: Spay Today Total of procedure(s) requested: $__________ One time Administrative Fee: $ + 5.00 Total amount due: $ _________ Drivers License Number (if paying by check) State_____#_________________ 2/8/2016 To set an appointment you may come in person to Briggs Animal Adoption Center, mail payment and information or call Spay Today and schedule over the phone with a credit card. You pay Spay Today, we set the appointment and we will go over the pre-surgery instructions with you. Hours Mon Tues Wed Thurs Fri Sat Sun 7:30am 7:30am 7:30am 7:30am 7:30am 8:00am closed 7:00 PM 5:00 PM 5:00 PM 7:00 PM 5:00 PM 12 noon 191 Augustine Ave Charles Town WV 25414 Phone: 304.728.2203 FAX: 304.724.0056 email hillsidevet@comcast.net Notes and Restrictions Keep records given at time of discharge, you will not be able to get a new copy. Pre-Surgery Instructions: - No food or drink after 8 pm the night before surgery. - Coupon must accompany pet at time of drop off - Drop off time is between 7:30am – 8:30am. New clients required to fill out information sheets upon arrival. - Cats must be in carriers and dogs must be on leash. - If cat/dog is in heat or pregnant, if dog weight is incorrect, you must pay the hospital the difference when your pet goes home. 2/8/2016