VIP Vaccination Request & Spay/Neuter Services

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PLEASE READ: If you wish to have your pet(s) vaccinated, microchipped or tested for heartworm and or FELV/FIV fill out this form. Only serious inquiries please, do not fill this form out if you are not seriously considering vaccinations.

NOTE: Beginning August 1, 2022 you pet(s) MUST BE spay or neutered to receive vaccination services from VIP Petcare through this program.

VIP Petcare will provide these RECOMMENDED vaccinations, microchips and tests to your family pet FREE of charge. PLEASE ADVISE US IF YOU DO NOT WANT ONE OR MORE OF THESE SERVICES.
Canine Distemper (5in1) vaccine
Canine Bordetella vaccine
Canine Heartworm Test
Feline FVRCP (3in1) vaccine
Feline FeLv/FIV Test
Microchip (Cat & Dog)

If your pet is 12 weeks or older and has never been vaccinated or it's been more than a year since their last vaccination, he or she will need a series of TWO vaccinations. Otherwise, puppy and or kittens 11 weeks and under will require a series of THREE vaccinations before 16 weeks of age. Your pet will automatically be scheduled for the next series at the time of your current visit. A volunteer will contact you to set up a Date of Service with you.

After this form is submitted, a volunteer from our team will contact you. He or she will share the details of the program and set up a Date and time for you to bring your pet(s) in.

Option 1

Clear selection

I UNDERSTAND THAT AS OF 8/1/2022 MY PET MUST BE SPAYED OR NEUTERED PRIOR TO RECEIVING VIP VACCINATION SERVICES.
*

ACKNOWLEDGED

Required

Applicants Full Name *

Applicants Full Address *

Are you a CPOC client? *

Yes

Applicants eMail Address *

Applicants Telephone # *

Can we text the applicant at this number? *

Yes

Would you like more information on our Spay/Neuter Program? *

Yes

Has your pet ever been vaccinated? *

Yes

Name of Pet # 1? *

Is Pet #1 a Cat or Dog? *

Cat

Dog

Breed of Pet #1? i.e Lab, Lab mix or Calico, Tabby *

How old is Pet # 1? Years, months, weeks *

Color of Pet #1? *

Weight of Pet #1? Give approx. weight. *

Gender Pet #1 *

Male

Female

Has Pet #1 been Spayed or Neutered *

CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE. Select ALL that apply: *

Yes, my pet needs their vaccinations. (Distempter and Bordetella)

Yes, my cat needs a microchip.

Yes, my dog needs a microchip.

Yes, my dog needs Heartworm tested.

Yes, my cat needs FELV/FIV tested. (Feline Immunodeficiency Virus, Leukemia Virus)

No, my pet does not need these services. I do not need more information.

Required

WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR? IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.
*

YES

Required

Name of Pet #2?

Is Pet #2 a Cat or Dog?

Cat

Dog

Clear selection

Breed of Pet #2? i.e Lab, Lab mix or Calico, Tabby

How old is Pet #2? Years, months, weeks

Color of Pet # 2?

Weight of Pet # 2? Give approx. weight.

Gender Pet #2

Male

Female

Clear selection

Has Pet #2 been Spayed or Neutered?

CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE. Select ALL that apply:

Yes, my pet needs their vaccinations. (Distempter and Bordetella)

Yes, my cat needs a microchip.

Yes, my dog needs a microchip.

Yes, my dog needs Heartworm tested.

Yes, my cat needs FELV/FIV tested. (Feline Immunodeficiency Virus, Leukemia Virus)

No, my pet does not need these services. I do not need more information.

WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR? IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.

YES

Name of Pet #3?

Is Pet #3 a Cat or Dog?

Cat

Dog

Clear selection

Breed of Pet #3? i.e Lab, Lab mix or Calico, Tabby

How old is Pet # 3? Years, months, weeks

Color of Pet # 3?

Wright of Pet # 3? Give approx. weight

Gender Pet #3

Male

Female

Clear selection

Has Pet #3 Been Spayed or Neutered?

CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE. Select ALL that apply:

Yes, my pet needs their vaccinations. (Distempter and Bordetella)

Yes, my cat needs a microchip.

Yes, my dog needs a microchip.

Yes, my dog needs Heartworm tested.

Yes, my cat needs FELV/FIV tested. (Feline Immunodeficiency Virus, Leukemia Virus)

No, my pet does not need these services. I do not need more information.

WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR? IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.

YES

Name of Pet #4?

Is Pet #4 a Cat or Dog?

Cat

Dog

Clear selection

Breed of Pet #4? i.e Lab, Lab mix or Calico, Tabby

How old is Pet # 4? Years, months, weeks

Color of Pet #4?

Weight of Pet #4? Give approx. weight.

Gender Pet #4

Male

Female

Clear selection

Has Pet #4 been Spayed or Neutered?

CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE. Select ALL that apply:

Yes, my pet needs their vaccinations. (Distempter and Bordetella)

Yes, my cat needs a microchip.

Yes, my dog needs a microchip.

Yes, my dog needs Heartworm tested.

Yes, my cat needs FELV/FIV tested. (Feline Immunodeficiency Virus, Leukemia Virus)

No, my pet does not need these services. I do not need more information.

WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR? IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.

YES

How are your pets around other dogs, cats, people? *

Has your pet had an allergic reaction to vaccinations in the past? *

Yes

Does your pet have any health issues, including dietary? If so, explain, If Not, use N/A. *

Every animal, every situation is different, please acknowledge that you understand that there may be a wait time during clinic hours. Know that VIP & CPOC will do everything in their power to remedy the situation quickly. *

Yes - I understand and will be patient

No - I cannot wait.

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