AnimalHospital of LargoLow 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: ______Weight: ______lbs
Has the above pet ever had a reaction to any vaccinations or medications □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** / Bordetella
** 2 booster series given 3-4weeks apart** / Intestinal Parasite check / Roundworm
and
Hookworm Deworming / Package Price / Package Savings
6-8 weeks of age Puppy Vaccines / ------/ Yes / Yes / Yes / Yes / $39.00 / $20.00
9-12 weeks of age Puppy Vaccines / ------/ Yes / Yes / Yes / Yes / $39.00 / $20.00
15 weeks and over of age Puppy Vaccines / Yes / Yes / ------/ ------/ ------/ $32.00(+$20 for county licensing) / $3.00
Adult Canine Packages:
Initial / Package Name / Rabies / Duramune Max 5 (5in1) / Bordetella / Intestinal Parasite check / Heartworm Test / Package Price / Package SavingsBronze / ------/ Yes / Yes / ------/ ------/ $35.00 / $4.00
Silver w/ 1 Year Rabies / Yes / Yes / Yes / ------/ ------/ $45.00 (+$20 for county licensing) / $10.00
Silver w/ 3 Year Rabies / Yes / Yes / Yes / ------/ ------/ $48.00 (+$20 for county licensing) / $11.00
Gold / ------/ Yes / Yes / Yes / Yes / $50.00 / $19.00
Platinum w/ 1 Year Rabies / Yes / Yes / Yes / Yes / ------/ $55.00 (+$20 for county licensing) / $15.00
Platinum w/ 3 Year Rabies / Yes / Yes / Yes / Yes / ------/ $58.00 (+$20 for county licensing) / $16.00
Diamond w/ 1 Year Rabies / Yes / Yes / Yes / Yes / Yes / $60.00 (+$20 for county licensing) / $25.00
Diamond w/ 3 Year Rabies / Yes / Yes / Yes / Yes / Yes / $63.00 (+$20 for county licensing) / $26.00
Initial / Individual Services / Price
Rabies 1 Year (PinellasCounty requires that all pets be vaccinated for rabies and Licensed) / $16.00(+$20 for county licensing)
Rabies 3 Year (PinellasCounty requires that all pets be vaccinated for rabies and Licensed) / $20.00 (+$20 for county licensing)
Duramune Max 5 (5 in 1)(Add Lepto for an additional $5.00) / $19.00 ($24.00 w/lepto)
Lyme (Borrelia Burgdorferi Bacterin) / $20.00
Bordetella / $20.00
H3N8 Influenza (Dog Flu) / $20.00
Intestinal Parasite Check / $15.00
Heartworm Test / $15.00
4 DX (Heartworm, Lyme ,Ehrlichia, Anaplasmosis) / $35.00
Nail Trim / $8.00
Hook / Round Worm Dewormer (Strongid T) / $9.00
Microchip(Price includes local numbing agent and Microchip registration) / $40.00
Puppy Health Certificates / Please inquire with office staff.
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.
***In the event of an emergency or sick case, examinations will be granted for established clientele.***
-Vaccine clinic prices, policies, and regulations apply ONLY during vaccine clinic hours (Thursday 8am – 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 atechnician 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. Medical examination charge is an additional $47.00.
-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 TheAnimalHospital 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 AnimalHospital of Largo responsible. I hereby assume all risks and give the AnimalHospital 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 PlusComfortis / Trifexis / Revolution / Other:
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.