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Application for Spay/Neuter services
If you need help getting your pet fixed, please complete and submit the following questionnaire or email it to angela@fixurpet.com. Our services are funded entirely by donations — we receive no government support. Before requesting assistance, please review our low-cost options to ensure help reaches those in greatest need. Important: You must provide a reachable phone number and regularly check your email for scheduling updates. If we cannot reach you, we will move on to the next applicant.
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
i have the following pets that need veterinary spay/neuter
*
dogs
Puppies
Adult cats
KIttens
Feral/outside community cats
I have ______cats that are not fixed
I have female cats or community cats that are
pregnant
Likely pregnant
nursing kittens
I have ______ male dogs that are not fixed
I have _______ female dogs that are not fixed
My female dog is
pregnant or possibly pregnant
in heat
under 6 months of age
My dogs are (check all that apply)
Under 20 pounds
20-40 pounds
40-60 pounds
Over 60 Pounds
I need help getting my pets fixed because
*
I am on SSI, a disabled veteran, or are on at least 2 forms of public assistance
I am homebound (need help with transportation)
I am a low income senior citizen
I have other financial burdens that make me unable to pay for services (loss of job, long term illness)
Other
Please provide us with any additional information about your pet or your financial situation that you would like us to know
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