Voucher Code (cat):
Total After Voucher (per cat)
Amount Discounted (per cat)
Voucher Code (dog):
Total After Voucher (per dog)
Amount Discounted (per dog)
Additional Info
Financial Assistance Request (CALIFORNIA)
Kindly provide us with the following information so that we can help you get the necessary assistance. To ensure that you are considered for all available funding sources, please answer all questions truthfully. We strongly advise against allowing financial limitations to prevent you from seeking medical attention for your animal. Let's work together to find a solution.
IMPORTANT NOTE:
This form does NOT register you for an appointment slot. If you are approved for financial assistance, you WILL need to still complete the regular clinic registration form on our website.
Your Name:
*
First Name
Last Name
Your Email:
*
Confirmation Email
example@example.com
Phone Number:
*
Please enter a valid phone number.
What state do you live in?
*
Please Select
AL
AK
AR
AZ
CA
CO
CT
DC
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
What California COUNTY do you live in?
*
(Some counties have spay/neuter assistance funds)
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Please apply at least 3 days PRIOR to the clinic you are intending to register for. We cannot guarantee a response in time if you apply less than 3 days before a specific clinic.
If financial aid is a constraint for you, please refrain from booking your appointment until we review your application. The $10 appointment deposit is non-refundable.
You MUST specify the LOCATION/DATE for a SCHEDULED clinic from our website that you are intending to register for.
We can ONLY provide assistance if we know WHICH particular clinic / date you wish to attend, since our funding can vary per clinic. We cannot review applications that do not specify a currently scheduled clinic location / date.
Have you already signed up online for one of our clinics?
*
Please Select
Yes
No
Which of our clinic location are you signed up OR intending to sign up for?
*
Example: Warsaw, IN
What is the date for this clinic?
*
-
Month
-
Day
Year
Date
How many animals do you own and/or feed currently?
*
(Including feral animals)
Are you requesting help for animals that are not yours?
*
Please Select
Yes
No
Please explain the situation for the animals that are not yours:
*
Do you house/care for all of the animals that you feed/own? Please explain:
*
(Often more funding options are available to multi-pet homes)
Please select which animal(s) you are requesting assistance for:
*
Cat(s)
Dog(s)
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How many cats do you want to bring to this clinic?
*
Please Select
1
2
3
4
5
6
Other
Select 'Other' if bringing more than 6 cats
Please specify the number of cats you want to bring:
*
Are any of the cats not owned?
*
Yes: Stray, Feral, or Abandoned
No: They are mine
No: They belong to someone else
Please provide us with the names and ages of the cats that you plan to bring:
*
The cost for our standard service is $100 per cat, which covers the examination, surgery, pain medication, and essential services. We kindly request that you inform us of the amount you are able to afford per cat. It is essential that you are upfront about your financial capacity, as we require this information to determine if we can provide financial assistance to you. We encourage you to be responsible and disclose the maximum amount you can afford, as this will assist us in seeking the appropriate aid. Failure to provide this information may hinder our ability to assist you adequately.
How much can you afford to pay per cat?
*
Please give us your best estimate
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How many dogs do you want to bring to this clinic?
*
Please Select
1
2
3
4
5
6
Other
Select 'Other' if bringing more than 6 dogs
Please specify the number of dogs you want to bring:
*
Are any of the dogs not owned?
*
Yes: Stray, Feral, or Abandoned
No: They are mine
No: They belong to someone else
Please provide us with the name(s), weight(s), and age(s) of the dog(s) that you plan to bring:
*
You MUST provide the approx weight(s) for your dogs in order for us to calculate how much assistance can be provided.
Our cost for dogs varies based on weight and whether the dog has previously had a litter (if applicable). The standard service covers the examination, surgery, pain medication, and essential services. We kindly request that you inform us of the amount you are able to afford per dog. It is essential that you are upfront about your financial capacity, as we require this information to determine if we can provide financial assistance to you. We encourage you to be responsible and disclose the maximum amount you can afford, as this will assist us in seeking the appropriate aid. Failure to provide this information may hinder our ability to assist you adequately.
How much can you afford to pay per dog?
*
Please give us your best estimate
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We kindly request that you provide us with details about your income. Please be honest in your response, as your income does not disqualify you from receiving assistance. It is important to note that this information will be kept confidential and only used to facilitate assistance for your animals.
*
Have you previously visited a veterinarian? If so, which veterinarian did you visit? Please inform us of the local veterinarian you contacted for spay/neuter services and their respective charges. In the event that you have not visited a veterinarian before, kindly let us know.
*
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Your personal story is often the most powerful motivator for donations. We kindly request that you share your circumstances with us and how our assistance would alleviate any difficulties in your life.
*
Are any of your animals being re-homed, or are any of your animals in need of new homes? Please explain. If there are new owners, please provide their information for the medical records.
*
Have any of your animals had litters before? If so, what did you do with them? Please explain.
*
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