Fetch N Fix Application
Low Cost Spay/Neuter Program
Please complete this form to apply for a spay/neuter voucher. Copay amounts are assigned based on eligibility and available funding. Vouchers are limited, non-transferable, and not guaranteed. Transportation assistance may be available on a case-by-case basis. Applicants must be the owner of the dog and a resident of Atoka or Pushmataha County. Maximum co‑pay: no more than $50. Final amount is determined after we review your application; please answer the eligibility checklist honestly.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Email
*
example@example.com
Sex - If you have more than 1 dog, we will follow up for additional information.
*
Male
Female
Age of Dog
Check all that apply
*
Veteran
Person with a Disability
I receive SNAP, WIC, or Medicaid
I have 3 or more unaltered pets in my household
This is an urgent situation (pregnant dog)
None of the above
Do you need help with transportation to a participating veterinary clinic? Transportation assistance is limited and provided on a case-by-case basis as approved by the program. Availability is not guaranteed and may depend on location, scheduling, and funding.
*
Yes, I may need assistance
No, I do not need assistance
If yes, briefly describe your situation
Agreement
I certify that the information provided is true and correct to the best of my knowledge. I understand that my copay amount will be assigned based on eligibility and available funding. I understand vouchers are limited, must be scheduled within 30 days, and are non-transferable. I agree to schedule and keep my appointment and to pay my assigned copay at the time of service. I understand that missed appointments or misuse of the program may make me ineligible for future assistance. Program Rules: Limit of 2–3 vouchers per household per year unless otherwise approved. All services depend on funding and veterinary availability.
Signature
*
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