Spay/Neuter Appointment

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Contact us at (662)-832-7633 or tubbproject@gmail.com if you have any questions about the application process.
** IF YOU HAVE MULTIPLE ANIMALS YOU WOULD LIKE TO SCHEDULE, PLEASE FILL OUT A NEW FORM FOR EACH ONE **

What is your yearly household income? **PRIORITY IS GIVEN IN ORDER OF NEED SO IN ORDER TO SCHEDULE YOUR PET'S SURGERY WE WILL REQUIRE YOUR PREVIOUS YEAR'S TAX RETURN. Send picture of tax return to 662-832-7633** *

First Name *

Last Name *

Phone Number *

Email *

Type of Animal *

Dog

Cat

Animal Name *

Animal Sex *

Female

Male

Weight of Animal (Approximate) *ONLY FOR DOGS* *

If you know your dogs exact weight, please pick the option that the weight is in. If you know the general weight range, check the boxes that are closest to your dog's weight. It helps us schedule more efficiently when we have an accurate weight of the animal.

1-10 lbs.

11-20 lbs.

21-30 lbs.

31-40 lbs.

41-50 lbs.

51-60 lbs.

61-70 lbs.

71-80 lbs.

81-90 lbs.

91-100 lbs.

101+ lbs.

I am scheduling a cat to be fixed.

I don't know.

Required

Animal Age (Approximate) *

Is your animal currently pregnant? *

Yes, I think so

No, not that I know of

Maybe/I don't know

N/A - My animal is male

Is your animal currently in heat? *

Yes

I don't know

N/A - My animal is male

Breed *ONLY FOR DOGS* (If you don't know, please put 'mix') (For cats, put N/A) *

Does your animal need a rabies vaccination?(Additional $10) *MUST BRING RABIES CERTIFICATE IF ANIMAL IS UP TO DATE ON VAX* *

Yes

No - It has already been administered by a veterinarian & I will bring the rabies certificate on the morning of surgery as proof.

Would you like for your animal to receive any of the following products/services? *

Microchip - Additional $15 (Includes lifetime registration)

E-Collar - Additional $10-15 depending on animal size

Nail Trim - Complimentary

No, I do NOT want any of the above products/services.

Required

Is there anything else you would like us to know about your animal?

I understand that if I am scheduling a cat to be fixed, I MUST bring the cat in a kennel. NO EXCEPTIONS.

Yes, I understand.

Clear selection

Who is your regular veterinarian?

I understand that whomever drops the animal off the morning of surgery will be responsible for signing our waiver.

Yes, I understand.

Clear selection

Price Subject to Change

We will give you a price estimate before the surgery but the price is subject to change depending on the weight of the animal in the clinic & any complications during surgery. Upon completion of the surgery we will give you a final price.

I understand that I will have to pay my bill in full upon pick-up in cash or using the Venmo app. *

Yes, I understand.

Required

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms