Cat Spay/Neuter Assistance Application 23

Cat Spay/Neuter Assistance Application

This program is for Saginaw County residents that are unable to afford spay or neuter surgery only please.
Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
County
How did you find out about the program?
To Qualify:

We may request proof of income be provided at time of surgery scheduling. We need a recent copy of pay stubs, unemployment, disability, or veteran benefits of ALL adult household members to determine eligibility. This program is designed for those that sincerely cannot afford to fix their pets on their own. Thank you.
Total number and ages of people living in the household?
Total annual household income (include all sources of income-ssi, unemployment)?
Are you:

Other
How many cats and kittens are there inside your home?
How many cats and kittens are there that you care for outside your home?
CAT 1 NEEDING SPAY/NEUTER
Name of the Pet:
Gender?
Age?
Weight?
How long have you owned the pet ?
Is this cat currently pregnant?
Is this cat currently, or has recently finished nursing kittens?
If this is a momma cat, how many kittens are there and how old are they?
Are you or an adult you trust able to transport your pet to Flint, Michigan where the surgery will be performed?
How much money are you able to contribute towards the spay or neuter of your cat?
Has this cat ever been seen by a vet?
Has this cat ever received vaccines
Are there any known medical conditions that we need to know about?
Where did you get this pet from?
If you have additional cats needing spayed or neutered please enter information below:
Should be Empty: