Spay/Neuter Registration

Spay/Neuter Registration
(READ FIRST - Due to High Demand for our low-cost Spay/Neuter Clinics, our current wait time can be up to 3 months for cats and 4-5 months for dogs. Please be aware of this before putting your pets on our list. ) Please fill out the following form and a volunteer will contact you to schedule a date (You may not hear from anyone for a few months). If you schedule your pet somewhere else, notify us ASAP so we can remove you from our list. (NOTE: We do not offer spay/neuter services for dogs over 75 pounds)
NOTE - PLEASE REVIEW ALL INFO ON OUR WEBSITE REGARDING PRICING AND LOCATION OF OUR CLINIC. https://www.athenshumane.org/spayneuter
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
TEXTING OK?*

YESNO
Email
example@example.com
FOR CATS -List cats name & gender (ex. Chester, Male)
FOR DOGS -List dogs name, gender and approx weight (ex. Spot, Male, 45 lb.)
CLINIC POLICY - If you fail to show up for your scheduled clinic date after confirming you will be there - you will never be rescheduled.*

I HAVE READ AND UNDERSTAND THIS POLICY
Do you qualify for reduced pricing for low-income clients? YES OR NO (To qualify for reduced spay or neuter prices you must: 1. Provide proof of Athens Co. residency with a photo I.D., utility bill, etc. 2. Provide proof of financial assistance from one of the listed qualifications •Ohio Works First schedule letter •Ohio Direction Card •WIC card •Section 8 housing voucher •Ohio Medicaid Card •Veterans Benefits Administration letter acknowledging service-related disability •Supplemental Security Income benefits letter •Disability benefits letter from the Social Security administration •Current tax return showing that your family income does not exceed 150% of the U.S. Department of Health and Human Services poverty guidelines (Bank statements and pay stubs do not qualify) *
If you are able - please attach a pic of your proof of financial assistance (example - Medicaid Card, Ohio Direction Card etc...) *You MUST show proof of financial assistance on the day of your appointment, if you do not submit it here, to qualify for the reduced rates, otherwise you will be charged the "standard rate" or your appointment will be cancelled.

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$25 Deposit PaymentThis amount will be deducted from your bill on your scheduled clinic date. *However, if you don't show up for your appointment this will not be refunded and you must re-register paying the deposit again.

$25.00

Total

$0.00

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Spay/Neuter Registration

NOTE - PLEASE REVIEW ALL INFO ON OUR WEBSITE REGARDING PRICING AND LOCATION OF OUR CLINIC. https://www.athenshumane.org/spayneuter

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