Rabies Clinic Forms and Scheduler

Huntington/Richmond Rabies Clinic Form
To schedule an appointment for the Rabies Clinic, first provide information about the Owner and the Pet(s) to be vaccinated. The Owner and Pet information entered on this form will show up on the completed Rabies Certificate, so please ensure it is correct.
No scheduled appointments are currently available, HOWEVER, the last 15 minutes of every hour are available for walk-in appointments and will be first-come, first-served. We prefer that if you plan to walk-in, you complete this form- it will expedite your appointment. When you arrive at your appointment, please let us know that you have provided your information/payment and we will have your certificate ready to go. Thank you!
To save the responses you've entered into this form and complete it at another time, click "Save" at the bottom of any page. Please note that using this feature does not reserve your appointment; your appointment time is not reserved until you click "Submit" on the last page.

If you have questions about this form, please contact noe@noelindemuth.com.

First: the Owner's info

Please enter the Owner's information for the pet(s) to be vaccinated.
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Phone Number*
Will be printed on the Rabies Certificate
Email*
For confirmation emails and appointment reminders, will not be printed on the Rabies Certificate

Next: your Pet's info
Enter the info, one at a time, for your pet(s). If you have more than one, please click the "add pet" button to add another section.

For age and size, decimals and whole numbers are acceptable. If entering a number less than 1, you must put the 0 in front of the decimal. For example, both 0.5 and 5 are accepted.
Pet Info*

Schedule an Appointment
No scheduled appointments are currently left. If you are walking in, you are welcome to skip this question and complete the rest of the form.
Appointment
Do you plan on registering a dog during your appointment?*

YesNo
Information on registrations will be sent to the email address provided after you submit.

Last question: Payment info
Vaccines are $20, and Microchips are $65.
How would you like to provide payment?*

With a Card, through this formWith a Check or Cash, at the time of my Appointment

Payment Portal

Vaccine

$20 Pets
Item subtotal:$0.00

Microchip

$65 Pets

Subtotal

$0.00

Tax

$0.00

Total

$0.00

Cash and Checks (made out to Dr. Kerry's Pet Housecalls) are all accepted at the time of your appointment.
Thank you for filling out this form! After you click submit, you'll receive an email with a summary of your entries.
Should be Empty:

Huntington/Richmond Rabies Clinic Form