MOBILE CLINIC FORM

Mobile Clinic Form

Form for mobile spay/neuter, vaccine, and microchips for both dog and cat.

IS YOUR PET 4 MONTHS OR OVER?(Required)

YES

STOP

Your pet is too young to be spayed/neutered! Please visit this form again when your pet is over 4 months of age.

OWNER'S INFORMATION

OWNER NAME(Required)

First Name Last

EMAIL(Required)

Enter Email Confirm Email

ADDRESS(Required)

Street Address Address Line 2 City State ZIP Code

PHONE(Required)

NUMBER TO CALL IN CASE OF EMERGENCY ON DAY OF SURGERY(Required)

PLEASE UPLOAD A PHOTO OF YOUR MILITARY OR VETERAN'S ID(Required)

Max. file size: 50 MB.

PET'S INFORMATION

IS THIS APPOINTMENT FOR A DOG OR CAT?

DOG

CAT

SECURED CAT CARRIER?(Required)

You must bring each individual cat in a secured cat carrier such as the one pictured here. Cardboard carriers are NOT accepted. Do you accept?

STOP

We require all cats being spayed/neutered to be dropped off during the time of their appointment in only a secured cat carrier, for their safety. Complete this form to schedule an appointment after you are able to confirm you can bring your cat in a secured cat carrier. Thank you!

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CAT INFORMATION

PET'S NAME(Required)

SELECT BREED*(Required)

*Some breeds are more prone to higher-risk during surgery and may require a separate community clinic exam prior to surgery.

STOP

Your pet is a breed that requires a community clinic exam appointment prior to scheduling their spay/neuter appointment. Please call (909) 623-9777 x 699 to make an appointment.

COLOR(Required)

PET'S GENDER(Required)

APPROXIMATE WEIGHT(Required)

AGE YEARS(Required)

AGE MONTHS(Required)

IS YOUR PET MICROCHIPPED?(Required)

DOES YOUR CAT NEED ANY VACCINES WHILE HERE FOR SPAY/NEUTER?(Required)

Select all that apply

Rabies

FVRCP

None

WOULD YOU LIKE YOUR CAT'S NAILS TRIMMED FOR AN ADDITIONAL $10?(Required)

Yes

IF YOUR PET IS OVER 7 YEARS OF AGE, AN EXAM WITH A VETERINARIAN IS REQUIRED PRIOR TO SURGERY.(Required)

We will call you to schedule an exam. Exam cost is $50, additional treatments/lab work may range from $100-250 in addition to the spay/neuter cost.

Yes, my pet is over 7 years of age.

No, my pet is younger than 7 years of age.

DOES YOUR PET HAVE ANY HEALTH ISSUES (EX. GROWTHS, HERNIAS, WEIGHT LOSS, ETC.)? IF SO, PLEASE EXPLAIN BELOW

Optional Anti-Nausea Medication (Additional Fee ~$30)(Required)

Yes, I would like Anti-Nausea Medication for an additional fee of ~$30

No, I do not want Anti-Nausea Medication

Optional Pre-Op Bloodwork (Additional Fee ~$130)(Required)

Pre-operative bloodwork can help identify underlying issues not visible during a physical exam, such as anemia or abnormalities related to liver, kidney, red cell, or white cell values. While bloodwork is not required for young, apparently healthy pets, it is available as a precaution and to establish a baseline before surgery.

Yes, I would like pre-op bloodwork performed for my pet, for approximately $130.

No, I do not want pre-op bloodwork preformed on my pet.

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DOG INFORMATION

PET'S NAME(Required)

BREED(Required)

*Some breeds are more prone to higher-risk during surgery and may require a separate community clinic exam prior to surgery.

STOP

Your pet is a breed that requires a community clinic exam appointment prior to scheduling their spay/neuter appointment. Please call (909) 623-9777 x 699 to make an appointment.

COLOR(Required)

PET'S GENDER(Required)

APPROXIMATE WEIGHT(Required)

AGE YEARS(Required)

AGE MONTHS(Required)

IS YOUR PET MICROCHIPPED?(Required)

DOES YOUR DOG NEED ANY VACCINES WHILE HERE FOR SPAY/NEUTER?(Required)

Select all that apply

Bordetella

DHPP

Rabies

None

WOULD YOU LIKE YOUR DOG'S NAILS TRIMMED FOR AN ADDITIONAL $10?(Required)

Yes

IF YOUR PET IS OVER 7 YEARS OF AGE, AN EXAM WITH A VETERINARIAN IS REQUIRED PRIOR TO SURGERY.(Required)

We will call you to schedule an exam. Exam cost is $50, additional treatments/lab work may range from $100-250 in addition to the spay/neuter cost.

Yes, my pet is over 7 years of age.

No, my pet is younger than 7 years of age.

DOES YOUR PET HAVE ANY HEALTH ISSUES (EX. GROWTHS, HERNIAS, WEIGHT LOSS, ETC.)? IF SO, PLEASE EXPLAIN BELOW

EX. GROWTHS, HERNIAS, WEIGHT LOSS, CRYPTORCHID (TESTICLE(S) HAVE NOT DESCENDED INTO THE SCROTUM) ETC.

Optional Anti-Nausea Medication (Additional Fee)(Required)

The pain medication given on surgery day can cause nausea in some pets. We recommend an optional anti-nausea injection (maropitant) to help reduce drooling, vomiting, and loss of appetite, and help pets return to normal appetite sooner after surgery. *Cost based on pet's weight: (0–25 lbs $30); (26–50 lbs $45); (51–75 lbs $55); (76–100 lbs $65); (101+ lbs $75)

Yes, I would like Anti-Nausea Medication for an additional fee*

No, I do not want Anti-Nausea Medication

Optional Pre-Op Bloodwork (Additional Fee ~$130)(Required)

Yes, I would like pre-op bloodwork performed for my pet, for approximately $130.

No, I do not want pre-op bloodwork preformed on my pet.

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END OF FORM

HOW DID YOU HEAR ABOUT US?(Required)

Website

Social Media

Billboard

Friend/Family

Other

PLEASE READ AND CONFIRM PRIOR TO SUBMITTING THIS FORM(Required)

Upon receiving your appointment date and time, a payment link will be sent. Please complete payment by the end of the day to secure your appointment, as unpaid appointments are subject to cancellation. If you need to cancel, reschedule, or do not attend, your deposit will be held as a one-time credit to reschedule. If you cancel or miss the rescheduled appointment, the deposit will be forfeited and is non-refundable. We do not offer refunds for canceled or no-show appointments.