Vaccine Clinic

This form is to RSVP for the Washburn County Area Humane Society Vaccine Clinic held 1-2 times per year.

May 2nd, 2026 Registration Please read before submitting: Dogs must be on a leash Cats must be in carriers $10/pet Payment is due at the clinic
Visit Type
Owner Information
First Name * Please type your legal first name.
Last Name * Please type your last name.
Phone * Please type your home phone number.
Email Address * Please type your email address. This will be used for receipt and confirmation.
Please confirm your email address.
Street Address * Please provide your address and apartment number if applicable.
City *
State *
Zipcode *
Select Appointment Time Please select a time period.
Appointment Time * Please select a time for your appointment. If you do not see a time slot this means it is full and was removed for selection.
Services Requesting * Please select all services you are requesting for this pet.	Rabies Vaccination Microchip
Pet Information
Species *
Pet Name * Enter your pet's name
Age of the Pet (Number only!) * Please type the age of the pet.
Gender *	Female Male
Breed *
Pet Color *
Neutered/Spayed? *
Is you pet Microchipped? *
Microchip Number * Please enter your pets microchip information
Has this pet had their Rabies Vaccination before? * Please answer honestly so that we can administer the appropriate dosage.
Vaccination Records (JPEG) * Please Upload a copy of the Vaccination Record

May 2nd, 2026 Registration