Thank you for your interest in a Wellness appointment at the Sandhills Spay Neuter Veterinary Clinic (SNVC), located at 5071 US Hwy 1 N, Vass NC 28394!
Please fill out the information below. At this time, all wellness appointments are scheduled on Thursdays.
Wellness Appointment Request Form
Sandhills Spay Neuter Veterinary Clinic - SNVC
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Are you currently receiving financial assistance such as Medicaid, Food and Nutrition, WIC, etc.?
*
Yes
No
If you answered YES to receiving financial assistance, please provide a copy of your benefits letter that includes a current date range.
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Patients Name
*
Is your Pet spayed or neutered?
*
Yes
No
Do you have a Male/Female/Cat/ or Dog
*
FEMALE Cat
MALE Cat
FEMALE DOG
MALE DOG
Patients Color and Breed
*
Patients Approximate Weight
*
Patients Approximate Age (weeks, months, or years)
*
You can now Take a Photo or Upload a Photo of your Pet for their medical record!
Patient Photo Upload
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Are you requesting an appointment for more than one Pet? If you answer yes, please complete a new form per pet.
*
Yes
No
Has your pet ever had vaccines or seen a veterinarian
*
Yes, my Pet has seen a Veterinarian
No, my Pet has never been to see a Veterinarian
Please provide a copy of your Pets vaccine history if available
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*** ALL WELLNESS VISITS INCLUDE A $35.00 EXAM FEEĀ ***
Please check which services you would like at the time of your Pets wellness appointment
Nail Trim ($10.00)
Ear Cleaning ($20.00)
Anal Gland Expression ($25.00)
Bravecto-Flea/Tick Prevention ($60.00 for a 3 month supply)
Microchip ($30.00 - includes lifetime registration)
Rabies Vaccine ($15.00)
Canine DHPP vaccine ($20.00)
Canine Lepto vaccine($20.00)
Canine Bordetella ($20.00)
Canine Heartworm Test ($30.00)
Iverhart Max (Canine) single month dose ($12.00)
Iverhart Max (Canine)-heartworm prevention 6 month supply ($55.00)
Feline FVRCP vaccine ($20.00)
Feline leukemia vaccine ($20.00)
Feline leukemia and FIV test ($35.00)
Capstar tablet - immediate flea infestation treatment ($15.00)
Fecal Exam ($25.00)
Deworming (pricing is based on patients weight)
Do you have any additional information on your Pet to provide?
Please verify that you are human
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