BHS Spay/Neuter Surgery Application

SPAY/NEUTER SURGERY APPLICATION

The Baltimore Humane Society | 1601 Nicodemus Rd | Reisterstown, MD 21136
BHS Roger P. Wagers Spay/Neuter & Vaccine Clinic

We are a subsidized spay/neuter program designed to provide low-cost, affordable spay/neuter surgeries and vaccines.
PLEASE READ AND COMPLETE THIS ENTIRE APPLICATION AS ACCURATELY AS POSSIBLE.

An $80 nonrefundable deposit will be required after submitting this application in order to book your appointment.

**If you have more than one pet that needs to be spayed or neutered, you MUST fill out a separate application for each pet you are scheduling.

If your pet has received vaccinations prior to this surgery, you MUST know your pet's vaccination history to complete this form. Please call your vet if you do not already have this information. Please note that the Baltimore Humane Society will only accept vaccines that are done at a licensed veterinary facility. We are unable to accept any vaccines done by breeders or that you have administered yourself.

The following form is to be used only for pets that you personally own. If you are trying to schedule a trap neuter and release appointment for a feral or stray cat, please call our office at 410-833-8848 ext. to make an appointment.

In order for your pet to qualify for surgery at Baltimore Humane Society, it must meet the following guidelines:

Your cat should:
- be between three months and seven years of age
- weigh at least 3lbs
- have no known illness, injury, or medical conditions
- not be a smoosh-faced breed of cat (Persian, Himalayan, British, Ragdoll etc.)
Your dog should:
- be between four months and seven years of age
- weigh between 5lbs and 60lbs if female or between 5lbs and 80lbs if male (if your dog is less than 10lbs, they will need to receive vaccines through the Wellness Clinic prior to day of surgery to avoid vaccine reactions that sometimes arise in small dogs when combined with anesthesia)
- have no known illness, injury, or medical conditions
- NOT be aggressive towards people or other animals
- not be a smoosh-faced breed of dog (Pug, English Bulldog, Boston Terrier, etc.)
*The drop off time for ALL Spay and Neuter appointments is between 8-8:30am and Pick up is the same day between 3-3:30pm. The owner of the pet must be present at the time of drop off to fill out consent forms. Please make arrangements in advance to be present at the time of your pet's appointment. Late fees apply.

Your Contact Information
First Name*
Last Name*
E-mail*

Confirmation Email
Phone Number*

Area CodePhone Number
Alternate Phone Number*

Area CodePhone Number
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
*PLEASE NOTE: The zipcode and income based grant that has been offered in the past is not available at this time. We are unforunately unable to offer that service for 2025. Please review the pricing listed on this application carefully before scheduling, as that is the current price for all appointments.
Do you qualify as low-income and live in one of the above zip codes?*

Your Pet's Information
Pet's name*
Species*
Is this a feral cat?
Feral cat appointments for our trap neuter and release program can not be scheduled online. Please contact our office at 410-833-8848 ext. 3 to schedule these.
Gender*
If male, are both testicles present?
Is this a stray or do you own this pet?
If you own it, how long have you owned this pet?*
Estimated Date of Birth (MM/DD/YYYY)*
Age of Pet (in years)*
Approximate weight (lbs)*
Breed*
Color/Pattern*
Is your pet nervous or aggressive at the vet or with strangers? (This may include anxiousness, growling, hissing, scratching, lunging, or snapping towards other animals or people.) *
It is very important for us to know how your pet acts at the vet and with strangers so we can handle them appropriately.
If yes or sometimes, please explain:
Has your pet ever had a seizure or chronic medical condition?*
If yes, please explain:

Your Pet's Medical History
Is your pet in heat?*
If your pet is in heat and it's a cat, surgery can be scheduled at any time. If your pet is in heat and it's a dog, surgery must be scheduled for at least eight weeks after vaginal bleeding has resolved. The average canine heat cycle lasts 10 days.
If your pet is a dog and you responded yes, when did it begin?
Could your pet be pregnant?*
If yes, approx. when did the breeding occur?
Has your pet recently had a litter?*
Pets who have recently had a litter should be scheduled for surgery 12 weeks or more after the birth.
If yes, when were the puppies/kittens born?
Is your pet currently on medication?*
Please include medication that you use occasionally, such as Trazadone for vet visits.
If yes, please list here:

Your Pet's Vaccination History
Baltimore Humane Society has certain requirements that must be met to receive surgery. Please consult your pet's vet records to complete this section of the application. If your pet has never been to the vet, if your pet's vaccinations are overdue, if your pet's vaccines were not given by a vet's office or rescue, OR if you do not know your pet's vaccine history, we will administer the following:
- FVRCP vaccine (cats) ($15)
- DHPP vaccine (dogs) ($15)
- Rabies vaccine (dogs and cats) ($15)
If your dog is 6 months of age or older, they will be required to receive a heartworm test ($20) IF they have no record of a negative heartworm test in the last year. This test is required even if they are on heartworm preventatives.

Please note that we can only accept vaccines that are done at a licensed veterinary facility. We are unable to accept any vaccines done by breeders or that you have administered yourself at home.

For the health and safety of your pets and others at the clinic, these policies are not negotiable. If your pet has received any of these services at another vet within the last year, please consult your records and include specific dates on this application to avoid having to receive these services again on the day of surgery.

Due to the risk of rabies transmission to people, you MUST provide proof of your pet's current rabies vaccination at the time of drop off for surgery. Proof includes an official rabies certificate or rabies vaccination record from your vet. The rabies tag is NOT proof of rabies vaccination. If you do not have proof, your pet will be given the required rabies vaccination at surgery.

Looking at your vet records, please answer the following questions.
Do you currently have a veterinarian?*
If yes, please include their name and phone number below:
Name and contact information of your veterinarian
What is the date of your pet's last rabies vaccine?*
You must present proof of vaccination at appointment. If your pet hasn't had a rabies vaccine, please enter N/A.
According to your vet records, when is this vaccine due again?*
If your pet hasn't had a rabies vaccine, please enter N/A.
What is the date of your pet's last FVRCP or DHPP vaccine?*
You must present proof of vaccination at appointment. If your pet hasn't had this vaccine, please enter N/A.
According to your vet records, when is this vaccine due again?*
If your pet hasn't had this vaccine, please enter N/A.
What is the date of your dog's last heartworm test?
This is NOT a fecal test. It is a blood test that can not be performed until your dog is at least 6 months of age. If your dog is under 1 year of age, your vet may not have performed this test yet.
Is your dog currently on monthly heartworm prevention?

Our Services
Please select all services that your pet needs.

Please note: Appointments are booked for the following month, so your pet will be 1-2 months older then it is now. Please select your options accordingly.
Spay/Neuter services*
Adults are 6 months of age or older. Juveniles are younger than 6 months of age.
Rabies vaccines*
Rabies is required to be given if your pet is not current or has never been given this vaccine
Distemper (DHPP for dogs, FVRCP for cats)*
DHPP/FVRCP is required to be given if your pet is not current or has never been given this vaccine
Heartworm Test (or 4dx test) (dogs)
Due to potential anesthetic risk in heart worm-positive dogs, the test is required before surgery if your dog is 6 months of age or older. This is a blood sample, NOT A FECAL TEST. If your dog is under 1 year of age, it is likely your vet has not performed this test yet. You may also choose to upgrade this to a 4dx test, which tests for heartworms as well as Lyme disease and 2 other tick borne illnesses.
Pre-anesthetic bloodwork is required for pets 5 years of age and older. Do you want pre-anesthetic bloodwork?*

What to Expect
Before your appointment, you will:
- keep your pet indoors after 8pm on the evening before surgery
- DO NOT feed your pet after midnight the day prior to surgery. This means no breakfast or treats before surgery, either. They can have water. (Kittens under 16 weeks of age are the exception—they should have a small snack for breakfast)
When you drop off for your appointment, you will:
- have your dog on a collar and leash
- have your cat in a labeled, clean cat carrier (only ONE cat per carrier)
- arrive between 8-8:30am on the day of your appointment (regardless of appointment time scheduled online). If you are late, late fees will apply. Please allot 15-20 minutes for drop off.
- bring your pet into the Spay/Neuter center to check in and complete a consent form
- pay for services at morning drop off—we accept cash or credit card. We are unable to take American Express or checks.
When you come to pick up your pet, you will:
- pick you pet up between 3-3:30pm
- if you are late to pick up, you will be charged late fees
- pets not picked up by 4pm may be subject to an overnight boarding fee
- please allot 15-20 minutes for drop off and pick up
If you arrive with a pet that is too anxious or fearful to be handled, is in a muzzle, or otherwise deemed unhandleable, we have the right to refuse service. Additionally, if your pet is injured, ill, in heat (dog), or outside weight range (please see beginning of form) we have the right to refuse service.

Completing this application is the first step in receiving a spay/neuter surgery for your pet from Baltimore Humane Society. Once you submit this application, you will be redirected to our online scheduling tool to schedule your pet's surgery. Due to high demand for surgeries, appointments book up quickly and there may not be immediate availability. If the system will not allow you to pick a surgery date, there are unforunately none left at this time. Please check back around the beginning of the month for more availability. We know the lack of appointments is fustrating and we appreciate your patience!

Once your appointment has been scheduled and your application has been reviewed, we will reach out to you to by phone or email with any questions, instructions, or information that needs to be clarified. Please make sure that we are able to reach you at the contact information listed on your application. Thank you.

If you need to cancel, please call us at least 48 hours before your appointment!

In the event of inclement weather the day of your appointment, please follow our winter weather policy: If Baltimore County schools are closed due to inclement weather, we will be closed that day as well, and we will contact you to reschedule. If schools have a two hour delay, we will still operate as normal.
I've read this thoroughly and I agree to all the services and fees selected above:*
Baltimore Humane Society requires that ALL dogs be on a leash or in a carrier and that all cats or small animals are in a secure carrier. For your pet's safety they will NOT be seen if they are not leashed or secure in a carrier.
Please type your name to sign this form:*
Please verify that you are human*
Please review your application thoroughly. Once it is completed, please press the "Submit" button below. Only press this button one time to prevent multiple submissions.

Once you submit the application you will be taken to our online portal where you can schedule your appointment online. An $80 nonrefundable deposit is required to book your appointment.

Please not that we do not reach out by phone or email to schedule you. If you are having issues with scheduling your pet's appointment in the portal, or your browser does not redirect you, please contact us by email at fixmypet@bmorehumane.org.
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SPAY/NEUTER SURGERY APPLICATION

BHS Roger P. Wagers Spay/Neuter & Vaccine Clinic