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Low Cost Spay/Neuter Clinic Application Form

  1. October 21, 2020 Clinic

  2. Responses to your application will be sent via email. Please add to your contact list to make sure it doesn't go to spam! If you have not received an email in 1-3 days after applying, please call us at 804-769-4983.

  3. You may only sign up 2 pets per Clinic per family! Please fill out separate applications for each pet.

    We cannot accept any dogs over 80lbs. If your pet weighs over 80lbs at check-in, it will be turned away.

  4. Pet's Gender*

  5. Pet Species*

  6. Example: Hound, Lab mix, Beagle. If cat, please state

  7. If cat, does it have short hair or long hair?*

  8. If yes, please list Breed. If no, please state.

  9. If unknown, please estimate.

  10. If unknown, please estimate.

  11. Would your pet be considered overweight for their breed?*

  12. Has your pet had puppies or kittens recently?*

  13. Could your pet be pregnant?*

  14. If your pet is a male, are both testicles descended?*

  15. Does your pet have any medical conditions (vaccine reactions, allergies, drug interactions, heart conditions, etc)?*

  16. Are your pet's vaccines up to date?*

  17. If not, which vaccines will you be purchasing?*

    Rabies Vaccinations are REQUIRED if your pet does not already have one. Vaccine prices are paid directly to the PETA Van Staff upon pick-up. CASH OR CREDIT ONLY. $20 MINIMUM ON CREDIT CARD CHARGES.

  18. Would you be interested in any other low-cost services such as:*

    Other service prices are paid directly to the PETA Van Staff upon pick-up. CASH OR CREDIT ONLY. $20 MINIMUM ON CREDIT CARD CHARGES.

  19. If your pet has not yet been seen by a Vet, please state.

  20. Has your pet ever had a seizure?*

  21. Has your pet ever tested positive for Heartworm Disease or Ehrlichia?*

  22. Has your pet ever been diagnosed with a heart murmur?*

  23. In the past 2 weeks, has your pet had any coughing, sneezing, diarrhea or other signs of illness?*

  24. Is there a chance your pet may already be spayed or neutered?*

  25. Does your pet have any skin issues or irritation?*

  26. Has your pet bitten anyone in the last 10 days?*

  27. Leave This Blank:

  28. This field is not part of the form submission.