RCAC Vaccine Appointment Request Form

RCAC Vaccine Appointment Request Form

Appointments are for healthy, well animals needing routine vaccinations ONLY. RCAC does not currently see sick or injured animals. If your animal is found to have a medical issue during the appointment, there may be an additional fee for doctor time spent addressing the problem with you. As of 1/1/2023, you must income-qualify to use our vaccine services.
Your Name*

First NameLast Name
Address*

Street Address

Apartment or Building Number

CityState / Province

Postal / Zip Code
Phone Number*
Alternate Phone Number
E-mail*
Have you been to RCAC with any pets in the past? As of January 1st, 2024, proof of eligibility is required for all clients, even if you have been seen in the last few years.*

YesNo
How did you find out about us?*
Please specify:

Do you meet any of the Tier 2 qualifications?
To qualify for Tier 2, you must be a current retiree collecting social security or have an annual income of $40,000 or less as indicated on the 1040 form of your most recent tax return.
Please attach verification of Tier 2 qualification here: *

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Congratulations!

It appears that your pet qualifies for vaccines at our clinic.
Please select the services you would like your cat to receive at the appointment:

Rabies Vaccine - This is a core vaccine required by law for all dogs, cats, and ferrets in New York State.FVRCP Vaccine - This is a core vaccine which protects cats from several contagious, viral respiratory and GI diseases, including "kitty parvo"Feline Leukemia Vaccine - Recommended for cats that go outside or frequently come into contact with other cats (cats may need to be tested for Feline Leukemia Virus prior to receiving vaccines)Combo testing for Feline Leukemia and Feline Immunodeficiency Virus - $35 with a package; $40 without a packageNail trim - $13Microchip - $40Dewormer medication - $8 - $18Flea & tick medication - Various pricesOther

Eligibility Requirements