Wellness Clinic Intake Form
- COMPANION ANIMALS ONLY 
- FOR FERALS & STRAYS, PLEASE CALL 845-452-7722 AND FOLLOW THE PROMPTS
- Services and pricing can be found at https://www.dcspca.org
- Please schedule appointments for each of your pets SEPARATELY while booking.  
- Beyond vaccinations, our clinic provides microchipping, diagnostic testing, and deworming. We can also recommend heartworm, flea and tick prevention suited for your pet’s lifestyle.  
- All vet records for your pet(s) will be emailed to you within 48 hours of your appointment.
- State-licensed veterinarians administer all cat and dog vaccinations, and we keep a record of your pet’s medical services for future appointments.

Please email your most recent vet records from your Primary Vet to wellness@dcspca.org. We need these in order to administer vaccinations. If you do not have records, our Vet will administer vaccinations as per NYS law.
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Full Name *
Home Address  *
Phone number *
Email address *
Requested appointment date *
Our public clinic appointments are every other Thursday from 10am - 2pm (Only listing appointments 3 months out - dates will not be available once they are full) One of our Vet Assistants will call to confirm the date of your appointment.
What time would you like to book your appointment? Appointments are 15 minutes for each pet. One of our Vet Assistants will call you to confirm the time of your appointment. *
Pet's Name
Pet Type *
Pet is Female or Male? *
Pet is Spayed or Neutered? *
Primary Breed of Pet? (if you don't know, mixed breed is fine) *
Pet's Colors *
Pet's Size/Weight (approximate is fine) *
Pet's primary veterinarian (if he/she doesn't have one, put DCSPCA) *
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