September 24, 2022 Vaccine Clinic

Due to limited space and high demand- we require payment within two business days of scheduling this appointment.

You will receive an email with a vaccine plan and must call in to make payment to avoid automatic cancellation.

Phone: 813-949-4416

NEW PATIENTS: If your pet is current on any vaccines, we require proof of vaccine history within this form upon scheduling. Upload vaccine record below.

UPLOAD PRIOR RECORD HERE

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Appointment

Primary Owner Name: *

First Name Last Name

Co Owner Name:

First Name Last Name

Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Phone Number *

Area Code Phone Number

Additional Phone:

Area Code Phone Number

Email *

example@example.com

Have you attended our facility before? *

Yes No

#1 Pet's Name: *

#1 Species: *

Dog Cat

#1 Pet's Age or D.O.B. *

Please note age in years or months

#1 Pet's Sex *

Male-Neutered Female-Spayed Male-Intact Female-Intact

#1 Pet's Breed: *

#1 Pet's Color: *

#2 Pet's Name:

#2 Species:

Dog Cat

#2 Pet's Age or D.O.B.

Please note age in years or months

#2 Pet's Sex:

Male-Neutered Female-Spayed Male-Intact Female-Intact

#2 Pet's Breed:

#2 Pet's Color:

GENERAL INFORMATION

What is a RABIES VACCINE for?
Rabies is a virus that affects the brain & nervous system of both people and animals- it is very serious and often fatal. The rabies vaccine is legally required by the state of Florida for all cats and dogs.

What is a RABIES TAG for?
Pasco and Hillsborough county both require rabies tags for all cats and dogs. Fees vary per county, per species and per altered or intact pets. We provide the tag and register your pet with your county (Hillsborough or Pasco), if we administer the Rabies vaccine.

What is a DAPP or CANINE DISTEMPER vaccine for?
The DAPP vaccine protects dogs against 4 serious diseases in dogs:
-Distemper: A highly fatal virus that attacks the respiratory, gastrointestinal, and nervous system of dogs. Infected animals commonly spread the virus through the air, and can shed the virus for months after exposure.
-Adenovirus Type 2: aka Infectious Canine Hepatitis, which causes respiratory disease in dogs.
-Parainfluenza: Highly contagious respiratory virus.
-Parvovirus: aka Parvo; A resilient, contagious disease that affects dogs’ gastrointestinal system. Most fatalities from parvo occur within 48 to 72 hours of onset of clinical signs. Symptoms include lethargy, vomiting, diarrhea, and lack of appetite. Parvo can contaminate almost any surface, survive many climates and stay in the environment for long periods of time.
*Puppies need vaccine boosters 3-4 weeks apart.
*Gentlecare Pet Hospital requires a current DAPP vaccine for all elective procedures.

What is a LEPTO vaccine for?
Leptospirosis is a disease that dogs can get from wildlife, but also can spread from animals to people. It is caused by a bacteria found worldwide in soil and water. The lepto vaccine is recommended if your pet is exposed to rural, wooded areas or areas with wildlife passing through.
*Initial vaccine needs booster 2-3 weeks apart.

What is a CANINE FLU VACCINE for?
Canine flu is a contagious respiratory disease: symptoms include coughing, sneezing, nose/eye discharge, and lethargy. This vaccine is recommended for “social” dogs and puppies that frequent training classes, grooming facilities, dog parks, and other areas where contact with multiple dogs is possible.
*Initial vaccine needs booster 2-3 weeks apart.

What is a BORDETELLA vaccine for?
Bordetella bronchiseptica causes coughing and illness in dogs by causing inflammation of a dog’s upper respiratory system. This vaccine is recommended for “social” dogs and puppies that frequent training classes, grooming facilities, dog parks, and other areas where contact with multiple dogs is possible. Some boarding and grooming facilities require this vaccine.

What is DEWORMER for?
Dewormer is a treatment given at our facility to take care of a broad spectrum of internal parasites in both cats and dogs, such as tapeworms, hookworms, roundworms and whipworms. Pets with parasites can experience symptoms like: anemia (blood loss), weight loss, diarrhea and vomiting. Intestinal parasites can be transferred to other pets and people. Parasites can live within a host without showing any signs or symptoms.
*Puppies/kittens need frequent deworming every 3-4 weeks before 6 months of age and every 6-24 months for adult pets.
*This dewormer treatment is in addition to your at home monthly flea/heartworm preventive.

What is HEARTWORM PREVENTIVE for?
Transmitted through mosquito bites, heartworms are a parasite that invade the heart and pulmonary arteries. Though easy to prevent, heartworm disease is very serious and potentially fatal. Even treatment is still high-risk and can be expensive. To prevent them, a monthly heartworm preventive can be given to your pet. In order to start on and stay on preventive, an annual heart worm test is needed for pets over 6 months old. Results are available within 10 minutes.

What is a FVRCP or FELINE DISTEMPER vaccine for?
The FVRCP vaccine is a vaccine that protects against 3 common feline diseases:
-Feline Viral Rhinotracheitis (Feline Herpes Virus): A respiratory virus transmitted by contact between cats or with contaminated objects like food and water dishes. Can lead to lifelong infection.
-Feline Calicivirus (FCV): A highly contagious virus affecting the upper respiratory system, with many infected cats becoming chronic carriers that can continue to spread the disease. Accounts for about 40% of all respiratory disease in cats.
-Feline Panleukopenia: A contagious and serious viral disease. Symptoms include fever, anorexia, vomiting, diarrhea, dehydration, and often septic shock.
*Kittens need vaccine boosters 3-4 weeks apart.

What is a FELINE LEUKEMIA VIRUS (FeLV) test and vaccine for?
FeLV is a viral disease that attacks the immune system of a cat, leaving them vulnerable to a host of secondary infections. Even though cats may show no signs of disease early on, over time it progresses and they may show signs like weight loss, bladder/skin infections, persistent fever and neurological disorders. It is the most common cause of cancer in cats and may cause various blood disorders. FeLV is spread through cat to cat contact, such as grooming and sharing food/water.
*Kittens need vaccine boosters 3-4 weeks apart.
*FELV testing is available with results in 10 minutes.

Check all that you plan to have done for your pet(s): *

I, the undersigned, do hereby certify that I am the owner (or authorized agent of the owner) of the above described animal, and to the best of my knowledge as the owner- my pet(s) is/are healthy and has no recent signs of sickness such as sneezing, coughing, vomiting, diarrhea, nor nasal or ocular discharge. Appetite and activity level is normal. I acknowledge the benefits of vaccinations for my pet(s) and authorize the above selections I have chose, at this time. I am aware that my pet(s) will only be examined for the appropriateness of vaccines selected. This is not a full and complete physical examination by the veterinarian. I understand adverse vaccine reactions, although rare may occur and in that event I as the owner will be responsible for any medical or emergency care necessary.

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