Spay and neuter request form
Thank you for reaching out to the HolliBell Foundation. Our mission is promoting the welfare of animals through the spaying and neutering of domestic pets, feral, or stray animals to better the community.
If you are looking for assistance with spaying and/or neutering for an animal under your care then please fill out the following form. Once your form has been submitted, our team will review your information and try to match you with one of our upcoming spay/neuter events or community partners. Please note that we do our best to find a solution for every animal, but submitting the form does not guarantee a spay/neuter spot for your animal. Please submit one form per animal.
Owner Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Pet Name
*
Pet Sex
*
Please Select
Male
Female
Pet Type
*
Please Select
Cat
Dog
Cat Breed
*
Please Select
Domestic Short Hair
Domestic Medium Hair
Domestic Long Hair
Abyssinian
Bengal
British Shorthair
Burmese
Cornish Rex
Devon Rex
Himalayan
Maine Coon
Manx
Persian
Russian Blue
Scottish Fold
Siamese
Sphynx
Turkish Angora
Turkish Van
Other
Do you already have a veterinary clinic, if so, please provide their name. If no, just type n/a
Cat Breed (Other)
*
If 'other' selected, please type breed of cat
Has your cat received a rabies vaccination?
*
Please Select
Yes
No
Date of Vaccination
*
-
Month
-
Day
Year
Date
Dog Breed
*
Please Select
Mixed breed - Small size
Mixed breed - Medium size
Mixed breed - Large size
Affenpinscher
Afghan hound
Airedale terrier
Akita
Alaskan Malamute
American Staffordshire terrier
American water spaniel
Australian cattle dog
Australian shepherd
Australian terrier
Basenji
Basset hound
Beagle
Bearded collie
Bedlington terrier
Bernese mountain dog
Bichon frise
Black and tan coonhound
Bloodhound
Border collie
Border terrier
Borzoi
Boston terrier
Bouvier des Flandres
Boxer
Briard
Brittany
Brussels griffon
Bull terrier
Bulldog
Bullmastiff
Cairn terrier
Canaan dog
Chesapeake Bay retriever
Chihuahua
Chinese crested
Chinese shar-pei
Chow Chow
Clumber spaniel
Cocker spaniel
Collie
Curly-coated retriever
Dachshund
Dalmatian
Doberman pinscher
English cocker spaniel
English setter
English springer spaniel
English toy spaniel
Eskimo dog
Finnish spitz
Flat-coated retriever
Fox terrier
Foxhound
French bulldog
German shepherd
German shorthaired pointer
German wirehaired pointer
Golden retriever
Gordon setter
Great Dane
Greyhound
Irish setter
Irish water spaniel
Irish wolfhound
Jack Russell terrier
Japanese spaniel
Keeshond
Kerry blue terrier
Komondor
Kuvasz
Labradoodle
Labrador retriever
Lakeland terrier
Lhasa apso
Maltese
Manchester terrier
Mastiff
Mexican hairless
Newfoundland
Norwegian elkhound
Norwich terrier
Otterhound
Papillon
Pekingese
Pointer
Pomeranian
Poodle
Pug
Puli
Rhodesian ridgeback
Rottweiler
Saint Bernard
Saluki
Samoyed
Schipperke
Schnauzer
Scottish deerhound
Scottish terrier
Sealyham terrier
Shetland sheepdog
Shih tzu
Siberian husky
Silky terrier
Skye terrier
Staffordshire bull terrier
Soft-coated wheaten terrier
Sussex spaniel
Spitz
Tibetan terrier
Vizsla
Weimaraner
Welsh terrier
West Highland white terrier
Whippet
Yorkshire terrier
Other
Dog Breed (Other)
*
If 'other' selected, please type breed of cat
Pet Colour
*
Please type the pet colour
Pet Age
*
Please Select
Under 3 months
4 months
5 months
6 months
7 months
8 months
9 months
10 months
11 months
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
Over 10 years
Pet Age (Under 3 months)
*
Please state how many weeks old
Pet Age (Over 10 years)
*
Please state how many years old
I receive support through the Ontario Disability Support Program (ODSP) or Ontario Works (OW) (Proof may be required)
*
Please Select
Yes
No
I have a case or social worker through ODSP or OW who can support my request for financial assistance with my pet's spay/neuter
*
Please Select
Yes
No
My pet will require transportation. PLEASE NOTE we do NOT provide transportation to all our options.
*
Please Select
Yes
No
Transportation Options. If you are interested in our Cedarview Animal Hospital option, we DO NOT provide transport to this location.
*
I have access to a vehicle
My pet will require transportation (+ $25) *THIS option is only available for our transport days.
Other *please indicate which option/location you are interested in
Waiver and Release Liability Form
I understand that I have requested transportation support to have my pet spayed or neutered. My pet must be healthy and safely prepared for the ride (dogs need to be leashed, muzzled if needed, and travel in a crate. Cats need to be in a hard carrier). Any questions or issues about the surgery or aftercare should be handled directly with the clinic. The HolliBell Foundation and its volunteers are not responsible for any medical problems or issues that occur during the transport.
I have read and understood the waiver and release liability form:
*
Yes
Name
*
First Name
Last Name
Date
*
-
Month
-
Day
Year
Date
Submit
Should be Empty: