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Low Cost Spay/Neuter Clinic Application Form

  1. January 2021 Clinic
  2. We do not have an exact date for the January Clinic yet. You will be notified if your pet has been accepted for the clinic & the date as soon as it's scheduled.
  3. Responses to your application will be sent via email. Please add to your contact list to make sure it doesn't go to spam!
  4. You may only sign up 2 pets per Clinic per family! Please fill out separate applications for each pet.

    We do not accept dogs over 80lbs!

  5. Pet's Gender*
  6. Pet Species*
  7. Example: Hound, Lab mix, Beagle. Please make a guess for mixed breeds even if you do not know for sure!
  8. If cat, does it have short hair or long hair?*
  9. If yes, please list Breed. If no, please state.
  10. If unknown, please estimate.
  11. If unknown, please estimate. We cannot accept dogs over 80lbs.

  12. Would your pet be considered overweight for their breed?*
  13. Has your pet had puppies or kittens recently?*
  14. Could your pet be pregnant?*
  15. If your pet is a male, are both testicles descended?*
  16. Does your pet have any medical conditions (vaccine reactions, allergies, drug interactions, heart conditions, etc)?*
  17. Are your pet's vaccines up to date?*
  18. If not, which vaccines will you be purchasing?*

    Rabies Vaccinations are REQUIRED if your pet does not already have one. You may not receive FeLV vaccines for cats unless they have had the FeLV/FIV test.

  19. Would you be interested in any other low-cost services such as:*

    Other service prices are paid directly to the PETA Van Staff upon drop off. CASH OR CREDIT ONLY. $20 MINIMUM ON CREDIT CARD CHARGES.

  20. If your pet has not yet been seen by a Vet, please state.
  21. Has your pet ever had a seizure?*
  22. Has your pet ever tested positive for Heartworm Disease or Ehrlichia?*
  23. Has your pet ever been diagnosed with a heart murmur?*
  24. In the past 2 weeks, has your pet had any coughing, sneezing, diarrhea or other signs of illness?*
  25. Is there a chance your pet may already be spayed or neutered?*
  26. Does your pet have any skin issues or irritation?*
  27. Has your pet bitten anyone in the last 10 days?*
  28. We will require proof of address when you drop your pet off at the clinic!
  29. Leave This Blank:

  30. This field is not part of the form submission.