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Low Income Spay/Neuter Appointment Booking
When:
Fridays
@ High Country Humane
Location:
11665 N Highway 89
Flagstaff, AZ 86004
Drop Off & Pick Up Info:
Drop Off: 8AM
Pick Up: 3:30-5PM
Important:
Cats & Dogs Only
1 Form Per Animal
2 Animals Per S/N Day
Must be a Coconino County Resident
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* Indicates required question
Email
*
Your email
Low Income Qualifier (you MUST have one of these to use our program):
*
Medicaid
WIC
SNAP
HCH Pet Food Bank Client
SSI
SSDI
Unemployment
Coconino County Spay and Neuter Program (DO NOT choose unless pre-approved)
License Plate Grant (DO NOT choose unless pre-approved)
Best Friends Grant (In Notes, write Number listed on bottom right of Voucher)
Required
Pick your S/N Date Below:
*
Friday, June 7th
Friday, June 14th
Required
First Name
*
Your answer
Last Name
*
Your answer
Mailing Address -
SERVICES AVAILABLE TO COCONINO COUNTY RESIDENTS ONLY
*
Your answer
Zip Code
*
Your answer
Phone
*
Your answer
Pet Name
*
Your answer
Species
*
Cat
Dog
Sex
*
Female
Male
Breed
(for cats: if unknown, write: short hair, medium hair, or long hair)
*
Your answer
Color:
*
Your answer
Age (please include month or year)
*
Your answer
Approximate Weight (kittens must be over 2 lbs)
*
Your answer
Notes (optional)
Your answer
A copy of your responses will be emailed to the address you provided.
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This form was created inside of High Country Humane DBA Paw Placement of Northern Arizona.
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