Animal Hospital of Largo Low Cost Vaccine Clinic
727-595-2287
Ahlargo.com
Owner (Last, First): _________________________________________ Phone Number: (____) _________-_________
Address: ___________________________________ City: _____________________ ST: _____ Zip: ______________
Pet Name: ________________________ Age: ________ Sex (Circle): Male Female Neutered/Spayed: □YES □NO
Breed: __________________ Color: _________________ Weight: _________lbs
E-mail for patient reminders: __________________________________________________________
Has the above pet ever had a reaction to any vaccinations or medications □NO □YES: ___________________________
If history of vaccine reaction, would you like a pre-vaccination injection to reduce the risk of reaction?
Cost $20.00 additional □NO □YES
How did you find us: __________________________________________________________________________________________
*** All dogs must be on leash, aggressive dogs muzzled ***
-We have the right to refuse any services to pets that are too fractious and/or aggressive-
Please initial all services you would like today:
Puppy Packages:
Initial
Package Name
Rabies
Duramune Max 5
(5in1)
**3-4 booster series
given 3-4 weeks
apart**
6-8 weeks of age Puppy
Vaccines
9-12 weeks of age
Puppy Vaccines
15 weeks and over of
age Puppy Vaccines
Bordetella
** 2 booster
series given 34weeks apart**
Intestinal
Parasite
check
Roundworm
and
Hookworm
Deworming
Package Price
Package
Savings
Yes
Yes
Yes
Yes
$39.00
$20.00
Yes
Yes
Yes
Yes
$39.00
$20.00
$32.00 (+$20 for
$3.00
Yes
Yes
Rabies
Duramune Max
5 (5in1)
Bordetella
Yes
Yes
$35.00
$45.00 (+$20 for
$48.00 (+$20 for
county licensing)
Adult Canine Packages:
Initial
Package Name
Bronze
Heartworm
Test
Silver w/ 1 Year Rabies
Yes
Yes
Yes
Silver w/ 3 Year Rabies
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Yes
Gold
Platinum w/ 1 Year
Rabies
Platinum w/ 3 Year
Rabies
Diamond w/ 1 Year
Rabies
Diamond w/ 3 Year
Rabies
Initial
Intestinal
Parasite check
Package Price
Package
Savings
$4.00
$10.00
county licensing)
$11.00
county licensing)
Individual Services
Rabies 1 Year (Pinellas County requires that all pets be vaccinated for rabies and Licensed)
Rabies 3 Year (Pinellas County requires that all pets be vaccinated for rabies and Licensed)
Duramune Max 5 (5 in 1) (Add Lepto for an additional $5.00)
Lyme (Borrelia Burgdorferi Bacterin)
Bordetella
H3N8 Influenza (Dog Flu)
Intestinal Parasite Check
Heartworm Test
4 DX (Heartworm, Lyme ,Ehrlichia, Anaplasmosis)
Nail Trim
Hook / Round Worm Dewormer (Strongid T)
Microchip (Price includes local numbing agent and Microchip registration)
Puppy Health Certificates
Doctor’s Examination
Yes
$50.00
$55.00 (+$20 for
$19.00
$15.00
county licensing)
$58.00 (+$20 for
county licensing)
$60.00 (+$20 for
county licensing)
$63.00 (+$20 for
county licensing)
$16.00
$25.00
$26.00
Price
$16.00 (+$20 for county licensing)
$20.00 (+$20 for county licensing)
$19.00 ($24.00 w/lepto)
$20.00
$20.00
$20.00
$15.00
$15.00
$35.00
$8.00
$9.00
$40.00
Please inquire with office staff.
$49.00
All vaccinations are given under the direction of a Veterinarian by a Veterinary Technician.
Please see information sheet attached to clipboard for explanation of vaccinations.
-
Vaccine clinic prices, policies, and regulations apply ONLY during vaccine clinic hours (Thursday 8 am
– 12 pm). No other discounts will be given at this time.
-
Packaged prices DO NOT include entire booster series.
-
All procedures performed and medications dispensed during the vaccine clinic are pre-paid.
-
If a client is opting for laboratory testing, it is the client’s responsibility to provide an up-to-date phone
number for the purpose of relaying requested laboratory results. The Animal Hospital of Largo will call
the provided number one time to relay results. It is the client’s responsibility to call back for results if
the Hospital cannot contact the client on the first call. We ask that clients call the Hospital to inquire
about laboratory results if they have not received a call within one week of the date of testing.
-
The Center for Disease Control (CDC) and the Animal Hospital of Largo recommend biannual
deworming and intestinal parasite checks every 6 months, as some internal parasites in animals can be
transmitted to humans (zoonosis). If you choose not to have an intestinal parasite check on your pet, you
are hereby accepting the risks of possible zoonotic disease exposure. Please inquire with a technician if
you would like more information.
-
No veterinary examinations are scheduled at the time and date of the vaccine clinic. If you would like
your pet to have a veterinary examination, please ask a staff member. We will be more than happy to do
an examination during your visit today if the doctor on duty is available or to schedule one during our
normal business hours.
The veterinarian and/or the Animal Hospital of Largo staff member holds the right to deem a pet
medically ineligible for any or all products, vaccines, vaccine packages, or other services.
-
-
Please check your receipt for information regarding vaccine reactions and the number of a local
emergency clinic.
By signing I verify that I am the legal owner or guardian of the pet being seen today for the vaccine clinic.
To the best of my knowledge, my pet is healthy with no allergies to vaccine(s) and had no recent
abnormal coughing, sneezing, vomiting, diarrhea, or eye discharge. I understand that The Animal
Hospital of Largo uses the best vaccines available for the low cost vaccine clinic; however, I also
acknowledge that a vaccine reaction is possible. Should my pet become ill due to a vaccination, I will not
hold Animal Hospital of Largo responsible. I hereby assume all risks and give the Animal Hospital of
Largo staff permission to vaccinate my pet for all elected vaccines.
Owner/Guardian Signature: __________________________________________ Date: _____________
In addition to the initialed procedures, I would like to purchase (Circle):
Advantage
Advantix
Vectra
Heartgard Plus
Tri-Heart Plus
Comfortis
Trifexis
Revolution
Nexguard
Bravecto
Please see info sheet on clipboard for explanation of products. By law, heartworm preventative can only be dispensed with proof
of a current negative heartworm test result.