Apollo Support & Rescue - Request for Spay/Neuter appointment
Email: ASRMedicalRequest@gmail.com
Bring your foster pet's folder to appointment.
Request Date
*
-
Month
-
Day
Year
Date
Pet Name
*
litter of puppies place the words - MULTIPLE PUPPIES
Species
*
Cat
Dog
Making the Request
Foster
Adopter
Staff
Who is dropping off
Foster
Adopter
Staff
Other
Who is Picking up
Foster
Adopter
Staff
Other
Contact Name
*
Person to schedule appointment with
Contact number call/Text
*
Email (you will get a copy once approved)
*
Please check your email
Preferred way of contact
Text message is fine
Please Call
Please email I check my email regularly
Does not matter
Please list dates and times you are available or any restrictions on dates and times.
*
label 1st, 2nd, 3rd for better communication
Your pet should have all their vaccination but if anything needs to be done during the Spay/Neuter please list that here. Please attach proof of all vaccination. They are required to scheduled this appointment.
Full Service Options
Animal Health Care Center - Arlington
Chisholm Ridge - Saginaw (Special circumstances only)
Park Place Pet Hospital - Southlake
Mazie's Mission - Carrolton
Location does not matter just tell me where I need to go
FIRST Choice of low cost clinic you would like
TCAP - Fort Worth
TCAP - Hurst
TCAP - Burleson
TCAP - Denton
Texas Paw Care - Basswood (Saturdays available)
Texas paw Care - off 121
Other
SECOND Choice of low cost clinic you would like
TCAP - Fort Worth
TCAP - Hurst
TCAP - Burleson
TCAP - Denton
Texas Paw Care - Basswood (Saturdays available)
Texas paw Care - off 121
Other
Chip ID
*
Contact Tara id you do not have this. It is also located on Kennel card.
DOB
*
-
Month
-
Day
Year
According to Petpoint (Ask Tara if you do not know)
Breed
*
Color / pattern
*
Sex
*
Male
Female
Weight of Pet
*
Approximate if unknown
Where is pet living
*
Apollo Facility
Foster
Pet has been adopted and lives with me the Adopter
Other
Has your Pet seen a vet before
*
No, has not seen a vet
Yes, Chisolm Ridge
Yes, Dove Creek
Other
Heart worm Status
*
Negative and current on preventative
Negative and needs preventative
Positive and still on doxy
Positive and finished doxy
Positive and have not started slow kill protocol
Unknown - Needs to be tested
Is your cat FeLV/FIV Tested?
*
Yes, Negative
No, has not been tested
Does your pet have Rabies vaccine?
*
Yes
No, needs at appt
Intake Date or estimated year and month of intake (Adopters we will fill this in)
Where did rescue pet come from
Stray
Owner surrender
Shelter
Long timer - had for years
Born in our care
I do not know I am the adopter
Other
Is there any personality issues we need to know of? (Example: Does not like men, flight risk, biter, high energy) List None if no personality issues
*
Is this foster being prepared for transport?
*
Yes
No
Departure Date
Receiver Information (Adopter or Rescue)
Transportation
Pets LLC 3701 Long Lane Rd Cookeville, TN 38506 Ph: 615-218-1589 Email: Petsllc@petsllc.net Vehicle: 2015 Freightliner Straight Truck
If an emergency occurs while your pet is here, and you are not present please select a CPR Code.
CPR - Yes Perform Emergency CPR and contact me the adopter
DNR - Do Not Resuscitate
Adopter's Signature - I approve the CPR choices above
Please attach medical records. They are REQUIRED to submit request
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please attach medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please attach medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please attach medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Please attach medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
SUBMIT NOW
OFFICE USE ONLY
Approved by
Please Select
Danielle Stewart
Cherie McCorvey
Marisa Hobbs
Medical Contact Email
example@example.com
Which Clinic is this Foster being sent to
Chisholm Ridge Pet Hosptial
Park Place Pet Hospital - Southlake
Animal Health Care Center - Arlington
Mazie's Mission - Carrolton
TCAP - Fort Worth
TCAP - Hurst
TCAP - Denton
TCAP - Burleson
Texas Paw Care
Other
Date and time of Appointment if know,
Pet is being prepared for transport
Yes
No
DOG SERVICES:
Wellness Exam
Rabies
DHLPP (Lepto)
DHPP
Bordetella
Fvrcp/Leuk
Dewormer - Strongid
Dewormer for Tapes
Heartworm Test
4DX Snap
Intestinal Parasite Float (Fecal)
Health Certificate
Nail Trim
Bath
Microchip Insert (Our Chip)
Heart Worm Prevention 1 m
Heart worm Prevention 6 m
Heart Worm Prevention 1 yr
Flea and Tick (Simparica)
Flea/Tick Puppy
Trazadone or other sedative
DOVE CREEK
Spay < 35 lbs $132(DC)
Spay 35-70 lbs $145(DC)
Spay > 75 lbs $172(DC)
Neuter 1-30 lbs $112(DC)
Neuter > 30 lbs $124(DC)
Pain Injection $16.50(DC)
Antibiotic injection $15.00(DC)
Carprofen or appropriate pain meds
CHISHOLM RIDGE
INCLUDED PAIN MEDS/INJECTION
Spay < 35 lbs $269(CR)
Spay 36-70 lbs $299(CR)
Spay 71-110 lbs $339(CR)
Neuter < 35 lbs $229(CR)
Neuter 36-70 lbs $259(CR)
Neuter 71-110 lbs $289(CR)
AHCC- Arlington
INCLUDES PAIN INJECTION
Spay < 50 $80(AH)
Spay > 50 $100(AH)
Neuter $65(AH)
In Heat $30(AH)
Over 60 lbs $1 per pound (AH)
PPPH - SOUTHLAKE
INCLUDES PAIN & ANTIBIOTIC INJECTION
Spay < 30 lbs $60 (PP)
Spay 31-60 lbs $70 (PP)
Spay 61-90 lbs ($75)
Spay 91+ lbs Needs Quote (PP)
Neuter < 30 lbs $55 (PP)
Neuter 31-60 lbs $60 (PP)
Neuter 61-90 lbs $65 (PP)
Neuter 91+ lbs Needs Quote (PP)
Take home pain meds (PP)
E-Collar
Pre-Surgical Bloodwork
Senior Panel Blood work
Crytorchid Abdominal
Cryptorchid Inguinal
Dental
Fill this in
CAT SERVICES:
Feline Spay (TCAP)
Feline Neuter (TCAP)
Feline Spay $35 (PP)
Feline Neuter $25 (PP)
Feline Flea/Tick
Felv/Fiv Combo Test
Pain Meds
E-Collar
If an emergency occurs while your pet is here, and you are not present please select a CPR Code.
CPR - Yes Perform Emergency CPR and contact me
DNR - Do Not Resuscitate
Does not apply staying with the pet
I authorize the above choice on CPR Code and I am aware of the charges.
Additional Medical Information - From Apollo Admin Team
Attach previous medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Attach previous medical records
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Back
ADMIN SUBMIT
Next
Doctor
Technician
Weight
Temperature
Lab Results
Exam Notes
Medication Sent Home
If spayed or Neutered - Place completed once it is done.
Sends notification to Admin to update pet's records
Submit
Should be Empty: