Josephine County Cat Microchip and Rabies Clinic 2nd Cat Registration

Please complete this form to register your 2nd cat

This information will be used for your pet's microchip information and rabies certificate. Please double check your entries for accuracy.

"*" indicates required fields

Contact Information

Name*

First Last

Main Phone*

Backup Phone

Address*

Street Address Address Line 2 City State ZIP Code

Email*

Pet Details

Pet Name*

Age: Year(s)*

Please enter a number from 0 to 20.

Age: Month(s)*

Please enter a number from 1 to 11.

Primary Breed(s)*

If unknown, please choose what they most look like.

Primary Color(s)*

Pet Hair Length:*

Short

Medium

Long

Sex of pet*

Male

Female

Is your pet spayed or neutered?*

Yes

What service(s) would you like your cat to receive today?

Microchip $15

Rabies $15

Both $30

1 or 3 Year Vaccine

All rabies vaccines administered will be 1-year vaccines, unless proof of prior rabies is approved by the veterinarian prior to the event.
To be considered for a 3-year vaccine, you may upload your pet's rabies vaccination certificate below. A picture of the certificate is fine. If you have problems uploading or locate the paperwork after you submit--call the shelter! Revisions can be made prior to the event, only.

Accepted file types: jpg, gif, png, pdf, Max. file size: 128 MB.

Clinic Procedures & Arrival Instructions

Vaccine Clinic Procedures & Arrival Instructions

You must remain in your vehicle until direction is given

Cats Only for this event (no dogs)

No children outside of vehicles

Please arrive only during your allotted time

The people working the event are volunteers. Please treat them with respect.

Failure to follow procedures or direction from our volunteers will result in us not being able to provide you service.

Vaccine Clinic Procedures & Arrival Instructions Consent*

I have read and agree to the above rules.

Full Consent

PLEASE READ AND CONSENT TO THE FOLLOWING TERMS BY CHECKING EACH BOX & SIGNING BELOW

I am the owner of the animal(s) presented for Rabies Vaccination, and I have the authority to give this consent for these procedures. I understand that the Veterinarians and certified vet technicians will perform the procedures to the best of their ability, always taking into account the safety of the animals first.*

I agree to inform anyone handling my animal(s) of any known risks of biting, snapping or any other risk that could cause harm.*

To the best of my knowledge, my animals have no allergies to vaccines. I will inform the Veterinarian and staff of any current medical conditions or medications that may increase my animals’ chance for adverse reactions to vaccinations. I understand that vaccine reactions are possible, though they are rare.*

If my animals become ill due to vaccines, I will not hold Josephine County, Shelter Friends, the Veterinarian or certified vet technicians responsible. I hereby waive and release Josephine County, its officers, agents, employees, and volunteers from any and all claims or losses which may arise from the rabies vaccination. I agree to treat any vaccine reactions at my own Veterinarian or emergency clinic at my own cost.*

I understand that this is not a complete exam for the overall health of my animals, and that my animals should be examined yearly by my own Veterinarian.*

My animals have had not recently had any illnesses such as coughing, sneezing, vomiting, diarrhea, runny eyes, runny nose, or fever. I certify that my animals are in good health. I understand that the clinic has the right to refuse to provide services if it will cause harm to my animals.*

I understand there are no refunds or exchanges for any of the services provided at this clinic.*

Signature*

Draw your signature if you read and agree to the terms above.

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