Low-Cost Spay/Neuter Surgery 
Please complete this form to apply for our low-cost spay/neuter assistance for your pet dog or cat. This is for pet owners on state or federal subsidized assistance (e.g., Medicaid, Disability, EBT, WIC, SSA/SSDI) This is also for seniors 65 years or older, veterans and anyone with tax documents showing adjusted gross income of $35,000 or less. 

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ABOUT YOU
Which of the following applies to you? *
Required
Our program is open to all Maury Co AND surrounding counties. Our clinic is located in COLUMBIA, TN. Drop-off is 7:00-7:30am and pick-up is usually between 1:00-3:00pm.  Are you, or someone you know, able to drop-off/pick-up your pet on time? *
What is your FIRST and LAST name? *
What is a good contact number? *
What is a good email for you? This will be the email you receive all documents and records so make sure you have access to it.  *
What is your home address? This is for our records, it does not determine whether or not you qualify for assistance. *
ABOUT YOUR PET
What are you needing spayed/neutered? *
What is your pet's name? Type TNR if community cat *
What is your pet's gender? *
What is your pet's age? *
How big is your pet? *
What is your pet's breed? (Best guess is fine) *
Where did you get your pet from? *
Will your pet need anything additional? *
Required
Does your pet have any medical or behavioral needs that we should know about?  *
How did you hear about us?
This program is not for individuals or groups who are going to ask for a rehoming or adoption fee for this animal. 

You will follow ALL post-op instructions.

If you do not show up or cancel your appointment, you forfeit any deposit you made and will no longer be eligible for any programs in the future. 
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