Reduced Cost Spay/Neuter/Microchip Application
READ THIS INFORMATION BEFORE COMPLETING THE APPLICATION! You may use this application form for four (4) pets for which you are requesting spay/neuter vouchers. If you need a spay/neuter for more than four pets, please complete another application for the remaining ones. With generous grants from community sponsors, we are offering our Spay/Neuter Assistance Program for a limited time only for LOW-INCOME Lancaster, SC Residents Only. Spay or Neuter Service: $20.00 for males / $30.00 for females. Price valid for cats and dogs at our veterinarian partner, Healthy Pets Spay, Neuter & Wellness Clinic in Rock Hill, SC. You must be able to provide your own transportation to and from the procedure in Rock Hill. Proof of current vaccinations is required. If your pet is not up-to-date on vaccinations, they will be provided at a reduced cost prior to surgery. Rabies vaccine: $5 and necessary adult booster vaccines are $5 each. Optional microchipping (includes lifetime registration): $25.00. Note that if the animal has evidence of fleas, a Capstar will be administered: $5. Once your application is approved, we will email a voucher to you that will be accepted at Healthy Pets. You will need to contact them directly to set up your appointment after you have received your voucher. Note: Pets must be up-to-date on all shots (proof required) or additional charges will be incurred. If you select other services from Healthy Pets that are not shown on your voucher, there will be additional charges incurred.
Today's Date
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Month
-
Day
Year
Date
Name
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First Name
Last Name
Email Address (Please type carefully. If your email address is wrong you will not get the voucher).
*
example@example.com
Would you like your email address added to the mailing list to receive the LSPCA monthly newsletter?
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Yes
No
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Total annual household income
*
Pet #1 Animal Type
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Cat
Dog
Pet #1 Name
*
Pet #1 Approximate Age
*
Pet #1 Approximate Weight
*
Pet #1 Gender
*
Male
Female
Pet #1 Breed (Lab, Hound, House Cat, Feral Cat, etc.)
*
Pet #1 - Has this pet even seen a vet?
*
Yes
No
Not sure
Pet #1 - Does this pet have a current rabies vaccine?
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Yes (Bring proof of current vaccines with you to your appointment)
No (You will be charged $5 for the required rabies vaccine)
Not sure (You will be charged $5 for the required rabies vaccine)
Pet #1 - Does this pet have a current distemper vaccine?
*
Yes
No
Not sure
Pet #2 Animal Type
Cat
Dog
Pet #2 Name
Pet #2 Approximate Age
Pet #2 Approximate Weight
Pet #2 Gender
Male
Female
Pet #2 Breed (Lab, Hound, House Cat, Feral Cat, etc.)
Pet #2 - Has this pet even seen a vet?
Yes
No
Not sure
Pet #2 - Does this pet have a current rabies vaccine?
Yes (Bring proof of current vaccines with you to your appointment)
No (You will be charged $5 for the required rabies vaccine)
Not sure (You will be charged $5 for the required rabies vaccine)
Pet #2 - Does this pet have a current distemper vaccine?
Yes
No
Not sure
Pet #3 Animal Type
Cat
Dog
Pet #3 Name
Pet #3 Approximate Age
Pet #3 Approximate Weight
Pet #3 Gender
Male
Female
Pet #3 Breed (Lab, Hound, House Cat, Feral Cat, etc.)
Pet #3 - Has this pet even seen a vet?
Yes
No
Not sure
Pet #3 - Does this pet have a current rabies vaccine?
Yes (Bring proof of current vaccines with you to your appointment)
No (You will be charged $5 for the required rabies vaccine)
Not sure (You will be charged $5 for the required rabies vaccine)
Pet #3- Does this pet have a current distemper vaccine?
Yes
No
Not sure
Pet #4 Animal Type
Cat
Dog
Pet #4 Name
Pet #4 Approximate Age
Pet #4 Approximate Weight
Pet #4 Gender
Male
Female
Pet #4 Breed (Lab, Hound, House Cat, Feral Cat, etc.)
Pet #4 - Has this pet even seen a vet?
Yes
No
Not sure
Pet #4 - Does this pet have a current rabies vaccine?
Yes (Bring proof of current vaccines with you to your appointment)
No (You will be charged $5 for the required rabies vaccine)
Not sure (You will be charged $5 for the required rabies vaccine)
Pet #4- Does this pet have a current distemper vaccine?
Yes
No
Not sure
ALL Pets - History of any medical problems of any of the pets named in the application (if known).
*
I would like my pet(s) microchipped with lifetime registration (add $25 for each chip)
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Yes
No
Other
I would like my CAT(s) to be given a Feline Leukemia (FeLV) and Feline Aids (FIV) test (add $35 pet cat for this test).
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Yes
No
N/A
Other
I need an E-collar ($10 each) for my pet(s). E-collars prevent the animal from harming themselves by licking or pulling on the stitches and opening the incision. E-collar is optional but highly recommended.
*
Yes
No
Other
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