General Help Form

Spay and neuter request form 2025

*****PLEASE check your JUNK folder for our response. We have had several people find our emails there*****
PLEASE NOTE ***we are currently adding people to a waitlist until funds are more available. 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. ***PLEASE ALSO NOTE - we typically respond within 48hrs-1week. If you do not hear back, please check your junk folder or email us again***
Owner Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Pet Name*
Pet Sex *
Pet Type*
Cat Breed*
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?*
Date of Vaccination*

MonthDayYear
Date
Dog Breed*
Dog Breed (Other) *
If 'other' selected, please type breed of dog
Pet Colour*
Please type the pet colour
Pet Age **PLEASE NOTE - pets over 5yrs old will require fluids for surgery. This is an extra costs*
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):*
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 *
My pet will require transportation. PLEASE NOTE we do NOT provide transportation to all our options. SOME TRANSPORTATION fees might apply depending on options *
We offer sponsored spots through the Lanark Leeds Grenville spay and neuter clinic in Brockville. If you wish to TAKE YOUR PET yourself please indicate YES in this box. We will send you the details for this option. *it does require a $75 deposit sent to the clinic in order to book.
WHICH option do you best see as a fit. Select all that apply.

Take my own pet to the Lanark Leeds Grenville spay and neuter clinic in Brockville *there is a $75 deposit to book this spot with the clinicTake my own pet to the Valley Vet Clinic in Carleton PlaceRequire transportation. This is not guaranteed. We only provide transport for catsOther, please send me all options so I can decideTake my own pet to the Ottawa Valley spay and neuter clinic in Kemptville. *there is a $75 deposit to book with them.
NOTES. If a caseworker has referred you, please add their name here
Waiver and Release Liability Form for TRANSPORT OPTIONS

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 NameLast Name
Date*

MonthDayYear
Date
Should be Empty:

Spay and neuter request form 2025

PLEASE NOTE ***we are currently adding people to a waitlist until funds are more available. 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.

Waiver and Release Liability Form for TRANSPORT OPTIONS