LSPCA Spay/Neuter Application

READ THIS INFORMATION BEFORE COMPLETING THE APPLICATION!

With generous grants from our community sponsors, we are offering our Spay/Neuter Assistance Program for a limited time only for LOW-INCOME Lancaster, SC Residents Only.
You may use this application form for up to 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.
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.
Additional fees will apply if the pet is in heat, pregnant, or has evidence of fleas.
You will be responsible to pay the veterinary hospital at the time of surgery for the services selected AND any other optional services you add at Healthy Pets Clinic.
Once your application is approved, a voucher will be emailed or mailed to you (usually within 7-10 business days) which will be accepted at Healthy Pets. You will need to contact them directly to set up your appointment after you have received your voucher.
Vouchers expire 90 days from date of issue.
Note that voucher recipients names may be shared for billing/reporting purposes.

IMPORTANT Notes:
Pets must be up-to-date on all shots (proof required) or additional charges will be incurred. If you select any optional services from Healthy Pets, additional charges will apply.

Kittens/cats need to be at least 2 lbs before they can be spayed or neutered and puppies must be at least 4 months of age.

I have read and understand the above information.*

YesNoOther - Please explain

Today's Date*

Date

Name*

First NameLast Name

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Phone Number*

Please enter a valid phone number.

Total annual household income*

I would like my voucher(s) to be:*

Emailed to meMailed to me at the above address

Email Address (Please type carefully. If your email address is wrong you will not get the voucher).*

example@example.com

IMPORTANT NOTES:

Kittens/cats need to be at least 2 lbs before they can be spayed or neutered.
Puppies must be at least 4 months of age.

Pet #1 Animal Type*

CatDog

Pet #1 Name*

A Pet's Name is REQUIRED. Application can not be processed without a pet name.

Pet #1 Approximate Age*

Pet #1 Approximate Weight*

Pet #1 Gender*

Male ($20)Female ($30)

Pet #1 Breed (Lab, Hound, House Cat, Feral Cat, etc.)*

Pet #1 - Has this pet ever seen a vet?*

YesNoNot sure

Pet #1 - 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 #1 - Does this pet have a current DAPP (for dogs), FVRCP (for cats) vaccine?*

Yes (Bring proof of current vaccines with you to your appointment)No (You will be charged $5 for this vaccine)Not sure (You will be charged $5 for the vaccine)

Pet #1 - I need an E-collar for my pet. 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 ($10).*

YesNo

Pet #1 - I would like my pet microchipped with lifetime registration ($25)*

YesNoNA

Pet # 1 - I would like my CAT to be given a Feline Leukemia (FeLV) and Feline Aids (FIV) test ($35).*

YesNoNA

Pet #2 Animal Type

CatDog

Pet #2 Name

A Pet's Name is REQUIRED. Application can not be processed without a pet name.

Pet #2 Approximate Age

Pet #2 Approximate Weight

Pet #2 Gender

Male ($20)Female ($30)

Pet #2 Breed (Lab, Hound, House Cat, Feral Cat, etc.)

Pet #2 - Has this pet ever seen a vet?

YesNoNot 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 DAPP (for dogs), FVRCP (for cats) vaccine?

Yes (Bring proof of current vaccines with you to your appointment)No (You will be charged $5 for the vaccine)Not sure (You will be charged $5 for the vaccine)

Pet #2 - I need an E-collar for my pet. 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 ($10).

YesNo

Pet #2 - I would like my pet microchipped with lifetime registration ($25)

YesNo

Pet #2 - I would like my CAT to be given a Feline Leukemia (FeLV) and Feline Aids (FIV) test ($35).

YesNoN/A

Pet #3 Animal Type

CatDog

Pet #3 Name

A Pet's Name is REQUIRED. Application can not be processed without a pet name.

Pet #3 Approximate Age

Pet #3 Approximate Weight

Pet #3 Gender

Male ($20)Female ($30)

Pet #3 Breed (Lab, Hound, House Cat, Feral Cat, etc.)

Pet #3 - Has this pet ever seen a vet?

YesNoNot 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 DAPP (for dogs), FVRCP (for cats) vaccine?

Yes (Bring proof of current vaccines with you to your appointment)No (You will be charged $5 for the vaccine)Not sure (You will be charged $5 for the vaccine)

Pet #3 - I need an E-collar for my pet. 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 ($10).

YesNo

Pet #3 - I would like my pet microchipped with lifetime registration ($25)

YesNo

Pet #3 - I would like my CAT to be given a Feline Leukemia (FeLV) and Feline Aids (FIV) test ($35).

YesNoN/A

Pet #4 Animal Type

CatDog

Pet #4 Name

A Pet's Name is REQUIRED. Application can not be processed without a pet name.

Pet #4 Approximate Age

Pet #4 Approximate Weight

Pet #4 Gender

Male ($20)Female ($30)

Pet #4 Breed (Lab, Hound, House Cat, Feral Cat, etc.)

Pet #4 - Has this pet ever seen a vet?

YesNoNot 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 DAPP (for dogs), FVRCP (for cats) vaccine?

Yes (Bring proof of current vaccines with you to your appointment)No (You will be charged $5 for the vaccine)Not sure (You will be charged $5 for the vaccine)

Pet #4 - I need an E-collar for my pet. 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 ($10).

YesNo

Pet #4 - I would like my pet microchipped with lifetime registration ($25)

YesNo

Pet #4 - I would like my CAT to be given a Feline Leukemia (FeLV) and Feline Aids (FIV) test ($35).

YesNoN/A

ALL Pets - History of any medical problems of any of the pets named in the application (if known).*

Please add any comments you may have:

Reduced Cost Spay/Neuter/Microchip Application