OFFICE USE ONLY: DOG PET WEIGHT: WELCOME ? HAVE YOU SIGNED UP SO WE CAN KEEP TRACK OF ARRIVAL ORDER ? FIRST visit to VetCare? YES / NO Just fill in owner & Pet name, Ill Visit or Wellness Care selected Owner_________________________________________________________________ Date ____/_____/_____ Address_____________________________________________ City _______________ Zip Code ____________ Phone_____________________________________ Cell Phone_____________________________________ May we contact you by email with Annual Wellness Reminders? YES NO Email (please print) ______________________________________________ How did you hear about our mobile wellness clinic? Walgreens Store Flyer Walgreens Outside Store Sign Friend Newspaper Drove by - Saw Clinic Walgreens Pharmacy Flyer vetcarepaw.com Website Craigslist Other_____________________________ Check (We do not hold checks) Credit Card (Visa/MasterCard/Discover) Dog’s Name___________________________________________ ~ Birthday ________ and __________ Method of Payment: Cash Month Breed: _____________________ Color: ___________________ Year Purebred Mixed Breed Gender: Male Intact Male Neutered Female Intact Female Spayed Behavior: Friendly Fearful Aggressive Bites Dog’s Health Status: Is your Pet healthy? YES NO My Pet is Ill and does not Has your Pet had a Heartworm Test ~ 1 year? YES NO need a Wellness Care Package Does your Pet have a chronic disease? YES NO Pet Consultation Does your Pet have a current disease? YES NO Has your Pet had previous vaccinations? YES NO + Diagnostics and Therapy YES NO (1st Visit and Follow-Ups) **! ? IS YOUR DOG ALLERGIC TO VACCINATIONS ? !** Previous Vaccinations Type $30 Fee Additional Information: ~ Date(s) Rabies 1 Year Rabies 3 Year* DHLPP+CvK Puppy DHLPP for Adults Bordetella Lyme Vax Influenza H3N8 Rattlesnake Vax Service FEES Applied per Pet Medical Waste Fee = $3.00 * We do not recommend and is not available ~ Visit Fee = Permits to Visit = $1.00 - $5.00 Only On Weekends 512-696-0976 ______ ______ ~ Fuel Surcharge = Depending on Gas Prices = $3.00 Contact Dr Steven L Meier drmeier@vetcarepaw.com Web Site vetcarepaw.com Adult Dog Wellness Packages Includes a Free Exam and Health Care Advice Saving ~ $50 Off Visits to Area Veterinary Hospitals $129 Best Package - DHLPP for Adult Dogs - Rabies – 1 Year with Certificate - Bordetella Intranasal - Lyme - Influenza H3N8 $98 Better Package - DHLPP for Adult Dogs - Rabies – 1 Year with Certificate - Bordetella Intranasal - Lyme $63 Good Package - DHLPP for Adult Dogs - Rabies – 1 Year with Certificate - Bordetella Intranasal $41 Minimum Package - DHLPP for Adult Dogs - Rabies – 1 Year with Certificate $45 Minimum Package < 2 yrs old + Add On - DHLPP + CvK for Adult Dogs - Rabies – 1 Year with Certificate Adult Dogs first time to be given any vaccination (except Rabies – 1 Year) require a minimum of 2 Vaccinations given ~ 4 weeks apart and thereafter repeated yearly Wellness Package ADD ONS or Build Your Custom Package w/ 2 Items Minimum $12 Rabies – 1 Year & Certificate $25 Heartworm Test $29 DHLPP for Adult Dogs $42 resQ Microchip (registration included) $22 Bordetella $71 Adult Dog Blood Profile (1-6 years) $35 Lyme $163 Senior Dog Blood Profile (7 + years) $31 Influenza H3N8 $33 DHLPP + CvK for Adult Dogs < 2 yrs old $28 Rattlesnake Individual Vaccinations - Do not include exam or advice unless Consultation is ordered $34 DHLPP for Adult Dogs $17 Rabies – 1 Year with Certificate $27 Bordetella $40 Lyme $36 Influenza H3N8 $33 Rattlesnake $38 DHLPP + CvK for Adult Dogs < 2 yrs Individual Care - Does not include exam or advice unless Consultation is ordered Only On Weekends 512-696-0976 $30 Heartworm Test $81 Adult Dog Blood Profile (1-6 years) $173 Senior Dog Blood Profile (7+ years) $47 resQ Microchip (registration included) Contact Dr Steven L Meier drmeier@vetcarepaw.com Web Site vetcarepaw.com Iverhart Max Oral Chewables (6 tablets/6 month supply) Prevents Heartworms and reduces intestinal parasites when given monthly $36 6-12 lbs $38 12-25 lbs $49 26-50 lbs $61 51-100 lbs * Heartworm Test within 1 - 2 years recommended to purchase especially if you sometimes forget to give it * Iverhart Max chewables (and other heartworm preventives) only reduce the threat of intestinal parasites, and every 6-12 month total worming therapy, is still required for complete protection of Pets and families (see Panacur C) Vectra 3D Topical (6 tubes/6 month supply) – Any size single tube $25 Kills fleas and ticks when applied topically to your pet once a month and repels ticks, mosquitoes, flies, mites, and lice $91 2.5-20 lbs $95 21-55 lbs $98 56- 95 lbs $102 > 95 lbs Panacur C Granules for Intestinal Worms (multiple packets to treat) Eliminates all intestinal parasites except tapeworms when given orally for 3 days every 6-12 months $11 <10 lbs $37 41-50 lbs $17 10-20 lbs $42 51-60 lbs $27 21-30 lbs $51 61-80 lbs $32 31-40 lbs $55 >80 lbs Droncit Injectable for Intestinal Tapeworms (1 dose) Given whenever segments (white “creepy crawlies” or dried “rice grains”) are observed on the stool, hair under the tail, or in Pet’s bed or sleeping area $25 <10 lbs $61 51-80 lb $32 10-25 lbs $64 >80 lbs $41 26-50 lbs Transmitted by fleas (See Vectra 3D) CET Oral Hygiene Chews (Package of ~ 30) Promotes dental and gum health and “Sweet Breath” when provided daily as a treat $13 Petites <11lbs Only On Weekends 512-696-0976 $18 Medium ~ 11-25 lbs Contact Dr Steven L Meier drmeier@vetcarepaw.com $24 Large ~ 26-50+ lbs Web Site vetcarepaw.com