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  • Low Cost Spay & Neuter Clinic Sign-Up Form

    Please complete the request for below. We have limited spaces for a given clinic. You will receive an email, phone call or text to review your pet's details before securing your appointment.
  • Format: (000) 000-0000.
  • I can best be reached by*
  • Pet Information

  • Note: Flat nose breeds (Frenchies/Persians) are $350 and will require special arrangements. Will be discussed over the phone after you submit this form.
  • Upload Pet Image
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  • Pet Type*
  • Pet Gender*
  • Requested Procedures

  • Upload Current Rabies Certificate
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  • Drop off location:*
  • If Gilroy, SCTW volunteers transport to/from Aromas. *If Aromas: When procedure complete, Snipbus will provide a required limited pickup timeframe between 45-60 minutes for dogs and 30 minutes for cats.

  • Authorization for anesthesia, tattoo, and surgery/Hold Harmless:

    I, the owner or authorized agent for the above pet, authorize the Veterinarian (DVM) and staff to provide medications, vaccinations, and to perform anesthesia and sterilization surgery (spay/castration) to prevent future reproduction. I understand my pet will be permanently tattooed for easy sterilization recognition. I understand for the purpose of today’s procedure, I am a client of DVM and that no pre-surgical tests are performed and that medical problems may arise as a result of conditions not identified by the examination. In the absence of negligence, I agree to hold harmless SCTW, SNIP BUS and the DVM if problems arise that may have been prevented had tests been performed. I understand risks exist with these procedures, that unforeseen conditions may arise, that no guarantee is made as to results, and that I should discuss any concerns that I have before surgery. I further understand that if my pet is brachycephalic, no additional treatments or protocols are taken, and my pet has a high risk under anesthesia and recovery that may result in death. I acknowledge that overweight and obese animals have a higher risk during surgery, including difficulty breathing, excessive bleeding and death. I certify to the best of my knowledge; my pet is in good health and not currently under DVM care. I have notified staff of any known allergies, medical concerns, or medications my pet has received in the last week. I certify all appropriate vaccinations are up to date for my pet or I have requested they be provided on procedure day. My pet is to be discharged same day. Prior to surgery, I will receive an outline of procedures to follow for at home care, as well as emergency information, since after hours care is not available at the SNIP Mobile Unit. I understand the above conditions.

  • Date*
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    2 digit month, 2 digit day, 4 digit year
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