Spay Today
PO Box 340
Charles Town, WV 25414
Kingdom Animal Hospital
Clearbrook, VA
* All In-heat, pregnant, obese or complications with surgery will have an extra fee of $43.50 due
to the vet at the time of pick-up.
**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) …………………..…..…………..$4
(Please circle procedure(s) requesting)
Cats: *
Female Spay
Rabies
Combo Test
Dogs: *
Female Spay (under 24 lbs)
Female Spay (25– 50 lbs)
Female Spay (51 lbs – 75 lbs)
Female Spay (75 lbs +)
Rabies
Heartworm Test
$122.00
$21.50
$35.75
Male Neuter
Feline Distemper (each)
Leukemia Vaccination (each)
$70.50
$31.00
$122.00
$138.50
$157.00
$211.75
$21.50
$23.00
Male Neuter (under 24 lbs)
Male Neuter (25 – 50 lbs)
Male Neuter (51 lbs – 75 lbs)
Male Neuter (75 lbs +)
Distemper (each)
Baby Teeth Extraction (each)
$103.50
$121.00
$136.50
$154.00
$31.00
$24.75
$21.50
Required Information:
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):_____________________
Payment information: Make payable to: Spay Today
Total of procedure(s) requested: $__________
One time Administrative Fee:
$
+ 4.00
Total amount due:
$ _________
Drivers License Number (if paying by check) State_________#______________________
2/12/2016