2026 SNIP application for dogs

Lollypop Farm SNIP Application for dogs

Please submit a separate application for each dog you wish to have spayed or 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. Please pay close attention to the final screen; if your application is denied at the point of submission, you may receive no further communication.
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.
Review the below qualifications for SNIP carefully
Name*

First NameLast Name
Address*

Street Address

Apartment or Building Number

CityState

Zip Code
Phone Number*
Format: 000-000-0000.
E-mail*

Confirmation Email
I understand that all communication for SNIP is delivered via email and that the email address submitted is correct and routinely monitored. I understand that Lollypop Farm is not responsible for missed, overlooked or inaccurately entered emails.*

Please upload your recent proof of New York state residency here. Acceptable proof will clearly show your name and address and should be dated within the last 60 days. Acceptable proof includes: New York State drivers license or non-driver ID, utility bills, government mail such as voter registration or tax bills. *

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Owner Eligibility
YesNo
Qualifying forms of public assistance are:

SNAP, Medicaid, Section 8 Housing Assistance, Safety Net Assistance, Family Assistance, or Supplemental Security Income.

Supplemental Security Income is NOT Social Security Income.
Please select the type of public assistance you are currently receiving.

Please attach verification of SNAP here. Acceptable verification of SNAP is your decision letter from The Department of Human Services.: **WE DO NOT ACCEPT NYS BENEFIT CARDS AS PROOF OF PUBLIC ASSISTANCE**

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Example of SNAP benefits letter below Cancelof

Please attach verification of Supplemental Security Income benefits here:

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Example of proof of Supplemental Security Income benefits below. Cancelof

Please attach verification of your Medicaid here. Acceptable verification of Medicaid is your current benefit letter from NYS of Health stating you are enrolled in a Medicaid plan **WE DO NOT ACCEPT INSURANCE CARDS OR BENEFIT CARDS AS VERIFICATION OF ELIGIBILITY**

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Example of proof of Medicaid benefits below Cancelof

Please attach proof of your Section 8 Housing Assistance here.

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Example of proof of Section 8 Housing Assistance below. Cancelof

Please attach proof of your Safety Net Assistance here. Acceptable proof of Safety Net assistance is your decision letter from The Department of Human Services. **WE DO NOT ACCEPT NYS BENEFIT CARDS AS VERIFICATION OF ELIGIBILITY**

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Please attach proof of your Family Assistance here. Acceptable proof of Family assistance is your decision letter from The Department of Human Services. **WE DO NOT ACCEPT NYS BENEFIT CARDS AS VERIFICATION OF ELIGIBILITY**

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Example of decision letter below Cancelof

YesNo
Please attach your adoption contract for your pet here.

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About Your Dog
Dog's name (If you wish to apply for multiple pets, please submit one application per pet):*
You may only enter one pet per application. Please submit a separate application for each pet.
MaleFemale
Age (years)*
If your pet is less than 1 year of age, enter "0" for years. Your dog must be four months of age NOW, as of the submission of your application, to be eligible for SNIP. DO NOT SUBMIT APPLICATIONS FOR DOGS UNDER FOUR MONTHS OF AGE.
Age (months)
Your dog must be four months of age NOW, as of the submission of your application, to be eligible for SNIP. DO NOT SUBMIT APPLICATIONS FOR DOGS UNDER FOUR MONTHS OF AGE.
Primary breed*
How much does your dog weigh (lbs), approximately? Please note that FEMALE dogs cannot exceed 90lbs in order to be eligible for SNIP.*
Female dogs must weigh less than 90lbs in order to be eligible for SNIP

YesNo

OneBoth
YesNo

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

YesNo
If yes, please list their current medical conditions and/or prescribed medications:
YesNo
If yes, please list the medical conditions, medication, or surgeries your dog has had, and how long ago they occurred:

YesNo

YesNo

YesNo

Additional Questions
How did you learn about the SNIP Program?*
If other please specify:
A note about stray pets

In order to be eligible for SNIP, dogs must be fully owned by the applicant and have been in the custody of the applicant for at least 30 days. If you found your dog as a stray, a good faith effort must have been made to locate an owner. Please see this page for information about reporting stray pets: https://www.lollypop.org/adopt/lost-found/if-you-find-a-lost-pet/
Where did you get your pet?*
If other please specify:
How long have you owned this dog?*
Have you sought assistance for spay/neuter from another source?*
If yes, what source?
Enter the message as it's shown*
Should be Empty:

Lollypop Farm SNIP Application for dogs

PLEASE NOTE

Review the below qualifications for SNIP carefully

Owner Eligibility

About Your Dog

Additional Questions

A note about stray pets