Spay Today PO Box 340 Charles Town, WV 25414 Heritage Animal Hospital Sterling, VA **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: Office visit (required for all visits) Female Spay ** Rabies (1 year) (required) Fecal Test Feline Leuk Vaccination (each) Dogs: * Office visit (required for all visits) Female Spay (under 20 lbs) Female Spay (21 – 45 lbs) Female Spay (46 – 65 lbs) Female Spay (66 – 85 lbs) Female Spay (86 - 100 lbs) Female Spay (101 lbs +) Rabies (1 year) (required) Bordetella (each) Leptospira Vaccination Lyme Vaccination * In heat, pregnant or obese $80 + additional $11 $84 $21 $24 $27.50 Pain Medication (required for spays) Male Neuter Feline Distemper(each)(recommended) Leuk/FIV/Heartworm Test $15.50 $64 $27.50 $38.50 $11 $109 $115 $131 $141 $151 $225 $21 $16.50 $16.50 $23.50 Pain Medication (required for all surgeries) Male Neuter (under 20 lbs) Male Neuter (21 – 45 lbs) Male Neuter (46 – 65 lbs) Male Neuter (66 – 85 lbs) Male Neuter (86 - 100 lbs) Male Neuter (101 lbs +) Distemper (each) (recommended) $15.50 $86 $89 $91 $95 $115 $155 $30.50 $38.50 $24.00 $25.00 Heartworm/Lyme/Ehrlichia Test Fecal Test CIV * * Other procedures offered at a discount, please call Spay Today for more information. 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_________#______________________ Heritage Animal Hospital 46950 Community Plaza #102 Sterling, VA 20164 703-444-4804 Phone 703-444-4867 Fax www.Heritageanimalvet.com Spay Today PO Box 340 Charles Town, WV 25414 304-728-8330 304-725-1523 Pre-Surgery Instructions 1. 2. 3. 4. 5. No food after midnight the night before surgery, do not take away water. Coupon must accompany pet at time of drop off. NO EXCEPTIONS! Drop off is between 7:45am to 9:30am. Cats must be in carriers and dogs must be on a leash. If cat or dog is pregnant or in heat or if the dog weighs more than originally described, owner must pay the difference at HAH when the pet is released. There is an additional fee for crypt orchid males. Obese patients may have an additional charge. 6. Anything not on voucher will be charged at full price and must be paid to HAH at time of patient discharge. 7. To reschedule or cancel an appointment, call the hospital and then call Spay Today with the new date. For cancellation, a 24 hour notice is required. 8. Pets should be picked up as close to 6:30pm as possible. Surgeries are performed early in the day, and pets should be recovered by 4pm. However, please call to be sure your pet is ready to be released. 9. Vouchers are valid for two months, are not replaceable, and must be returned to Spay Today for refund, if necessary. Everything is refundable except the $4.00 administration fee. Treat vouchers as you would cash. 10. If rabies vaccine is not purchased from HAH, a valid rabies certificate must be presented to the Veterinarian at time of hospitalization or else another vaccine must be given by HAH and billed to the owner. Double-vaccination will not be harmful to your pet, but is an added expense not necessary if owner complies. 11. Pets’ nails will be trimmed while under sedation at no charge to owner. If this service is not desired, please inform check-in receptionist. 12. A new-client information sheet and surgery admitting form will be presented for owner to fill out and sign. Please allow a few minutes at drop-off time to complete 13. If your pet has fleas, a flea dip will be done at your expense.