No Kill Glynn County 2026 Fix-a-Pit-Low Cost Spay/Neuter
Please fill out this form in entirety to ensure we can provide your pet with the best possible care. This opportunity has been made possible thanks to a generous grant from Marcia Brady Turner Foundation.
Owner's Information:
Name
First Name
Last Name
Phone Number
Please enter a valid phone number.
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
example@example.com
Owner's Venmo or PayPal Account Name or @Username
Dog's Information
1 dog per form
Dog's Name
*
First Name
Last Name
Dog's Breed
Dog's Age
Dog's Approximate Weight
Dog's Color
Is the dog male or female?
Please Select
Male
Female
Who is your dog's primary veterinarian?
Does your dog have any known medical issues? (for example allergies)
Yes
No
If you said yes to medical issues, please explain:
Does your dog have any known behavioral issues?
Yes
No
If you said yes to behavioral issues, please explain:
Is Your Dog Up-To-Date On Rabies Vaccine?
Yes
No
I Am Not Sure
If you answered YES to your dog being up to date on their rabies vaccine. Please bring proof of rabies with you to the spay/neuter appointment via rabies tag or certificate. If proof is not shown, your dog will be given another rabies vaccine the day of the surgery. Please select "I understand".
I understand
If you answered NO to your dog being up to date on their rabies vaccine, an up-to-date rabies vaccine is required by GA state law. This can be done at the time of the spay neuter appointment. Please select "I understand".
I understand
Do you want your dog microchipped? (Additional Fees Owner Would Be Responsible For Apply)
*
Yes $55.00
No
No, my pet is already microchipped
Additional Questions:
Do you have a safe/clean place inside for your dog to recuperate from surgery and be contained for low activity for 7-10 days after surgery? (This is especially important for spay surgeries)
Yes
No
Do you have a crate that can be used for recovery time (7-10 days) after surgery to limit activity?
Yes
No
Do you have transportation to take your dog to the appointment and pick up from the appointment? Most vet offices we work with ask for them to be dropped off before or at 8am and can be picked up 4:30-5:30pm. All vet offices we will be partnering with are within Glynn County. *If you do not have transportation, we can do our best to find volunteers to help with transporting to and from the appointments.*
Yes
No
I'll need help with transportation
Is There Anything Else We Should Know About Your Pet?
If yes, please tell us more. If no, please note N/A
NEXT STEPS
1. Submit this application. 2. Once this application is approved, you'll hear from one of our volunteers to let you know it has been approved. 3. After application approval, you will be required to pay the non-refundable $35 appointment fee, per dog. This fee is to be paid to our Venmo- @nokill-glynncounty PayPal- @nokillglynncounty or CashApp- $NoKillGlynnCounty 4. Once we receive payment, we will contact you to acknowledge payment and get your appointment scheduled. Please note that once appointments are made any cancellations or no-shows will result in not being rescheduled for future surgeries. We will only be scheduling about a month at a time. Please initial that you understand the process.
*
Initial
Authorizations
I agree to have my dog spayed or neutered through this program and to allow the veterinarian to give my dog the rabies vaccination, required by law, prior to surgery if my dog is not vaccinated and if proof of rabies is not provided to the vets office on the day of surgery.
*
Initial
I give consent for my dog to be included in NKGC social media posts.
*
Initial
I understand that No Kill Glynn County and partner vets have the right to deny services that we feel are not in the best interest of the animal.
*
Initial
I authorize treatment of my pet to be performed by the vet offices partnering with No Kill Glynn County. I authorize the use of anesthesia and other medication as deemed necessary by the veterinarian and understand that hospital personnel will be employed in the procedure as directed by the veterinarian.
*
Initial
I understand the nature of this procedure to be performed and the risks involved. No guarantees have been made regarding the outcome or cure. I understand that there is always a risk associated with any sedation or anesthesia episode, even in apparently healthy animals, and have discussed my concerns with the veterinarian. This risk includes serious bodily injury or death. I understand that it may be necessary to provide medical and/or surgical procedures which are not anticipated for the safety or care of my pet. I hereby consent to and authorize the performance of such altered and/or additional procedures as are necessary in the veterinarian’s professional judgment.
*
Initial
All of the information on this form is true to the best of my knowledge. I verify I am the owner of the dog listed on this application.
*
Initial
Do you have any questions or concerns for the No Kill Glynn County Team?
If yes, please tell us more. If no, please note N/A
Signature
*
Date
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Month
-
Day
Year
Date
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