Spay/Neuter Surgery Appointment Request

Spay/Neuter Appointment Request

Complete this form to request a spay/neuter appointment

for your dog or cat.

Submit one form PER PET.

Submitting this form DOES NOT mean you have an appointment.

After receiving your form, you will receive a follow-up phone call

to schedule and pay for your appointment.

Payment is due at the time of scheduling. Please do not submit

a request if you are unable to pay at the time of submission.

If you have any problems, please contact us at 208.772.4019.
Your Name *

First Name Last Name
Email Address *
Primary Phone Number *

Area Code Phone Number
Work Phone

Area Code Phone Number
The primary phone number listed above is the number we will call to schedule your appointment.
Address *

Street Address

Apartment/Suite/Unit #

City State

Zip Code
Species *

Cat Dog
Sex *

Female Male
Animal's Name *
Breed *
List dog breed. Cats list short, medium, or long hair.
Age *
All dogs/cats must be a minimum of 16 wks old.
Weight for dog
Which days of the week work best for you (check all that apply):

Tuesday (every week) Thursday (every week) Friday (twice a month)
Important - answer the following questions accordingly.

Does your pet currently have, or has ever had the following (mark all that apply):
Heart condition (murmurs, arrhythmia) *

Yes No
Tracheal problems (collapsing trachea, kennel cough, upper respiratory) *

Yes No
Kidney or Liver problems *

Yes No
Seizure disorders *

Yes No
Is your pet on any medication/s *

Yes No
If your pet is on medication/s, please list below:
Are you interested in adding any of the following services (check all that apply):

Dog DA2PP Rabies (dog or cat) Dog Bordetella Microchip Cat FVRCP
I understand that female dogs 7-yrs and older are not available for spay service under this program. *

Yes
I understand that female cats 10-yrs and older are not available for spay service under this program. *

Yes
I understand flat-face dogs and cats are subject to an extra $25 charge. Charge is determined by KHS vet. *

Yes
I understand I do not have a scheduled appointment until I receive a phone call from KHS. *

Yes
I understand that I am required to pay by credit card over the phone when I am contacted. *

Yes
Thank you for your submission. We will be in contact as soon as possible to schedule your appointment (this can take 24-72 hrs). If after that time you do not receive a phone call to schedule your appointment please contact us at 208.772.4019.
Should be Empty:

Spay/Neuter Appointment Request

Important - answer the following questions accordingly.