2024/2025 Male Dog App

PLEASE NOTE

SNIP provides lower-cost routine spay and neuter surgeries to animals in good general health and is NOT a provider of emergency surgeries. If your pet is experiencing a medical emergency, please contact your full service veterinarian or visit https://www.lollypop.org/resources/emergency-veterinary-services/ to view our listing of regional emergency veterinary facilities. You may also call us at (585) 223-1330 for guidance on accessing care for your pet.
2024/2025 SNIP Application for Male Dogs

Please submit a separate application for each dog you wish to have neutered through the SNIP program. Please note that SNIP surgeries are not guaranteed and animals may be refused service at any time for medical or behavioral reasons; failure to disclose health or behavioral challenges prior to your appointment will result in immediate cancellation of surgery and forfeiture of your deposit.
Full Name *
First & Last Name
Address*

Street Address

Apartment or Building Number: Otherwise n/a

CityState

Zip Code
E-mail*
Contact Phone Number*

Owner Eligibility
Do you receive any of the below listed forms of public assistance? (If your household income falls below the HUD income eligibility guidelines, answer NO to move on.)*

YesNo
Qualifying forms of public assistance are: SNAP, HEAP, Supplemental Security Income, Social Security Disability Income, Unemployment, or Medicaid.

Income Eligibility Limits by Household Size

1 Person:

2 People:

3 People:

4 People:

5 People:

6 People:

7 People:

8 People:

$33,950

$38,800

$43,650

$48,500

$52,400

$56,300

$60,150

$64,050

About Your Dog

Please submit a separate application for each pet you wish to have neutered through the SNIP program.
Dog's Name*
You may only enter one pet per application
Sex:*

MaleFemale
Age (years)*
Dogs must be at least 3 months of age to apply. If less than 1 year, please enter a 0 for years. Do NOT submit an application if your pet is not yet of age.
Age (months)
Dogs must be at least 3 months of age to apply. Do NOT submit an application if your pet is not yet of age.
Primary Breed*
How much does your dog weigh (lbs), approximately? Please note that FEMALE dogs cannot exceed 90lbs in order to qualify for SNIP.*
Female dogs cannot exceed 90lbs in order to qualify for SNIP

Is your dog nursing puppies?

YesNo
Puppies need to continue to nurse until they are about 6-8 weeks and mostly eating dog food. Dogs should be at least 4 weeks past birth to apply for SNIP.
If yes, on what date did your dog give birth?

Is your dog current on vaccinations? (specifically rabies and DAPP)*

YesNo
Is your dog currently being treated for any medical conditions and/or currently taking any medications?*

YesNo
If yes, please list their current medical conditions and/or prescribed medications:
In the past, has your dog been treated for any medical conditions, been prescribed any medications or had any surgeries?*

YesNo
If yes, please list the medical conditions, medication, or surgeries your pet has had, and how long ago they occurred:

PLEASE NOTE