P.A.W.S. LOW COST SPAY/NEUTER PROGRAM
Application Date: _______
Owner’s Name: ______________________________________________
Owner’s Phone Number(s): ____
PET INFORMATION
Owner’s Email:
City: ________________________________
____________
__
______________
Pet Name: _________________________
Cat or Dog
Male or Female
Pet Age: __________*
Have Vaccine Proof? Yes or No
Pet Name: _________________________
Cat or Dog
Male or Female
Pet Age: __________
Have Vaccine Proof?
Pet Name: _________________________
Cat or Dog
Male or Female
Pet Age: __________
Have Vaccine Proof? Yes or No
Breed of Dog:
For office use ONLY:
Approx. Weight:
Is your pet in heat or pregnant?
Circle One
PAYMENT TOTALS
(Low Cost / Low Income)
Number of Dogs (SPAYING or Neuter) __________ X $ 75 / $ 50 = __________________
Number of Cats (SPAYING or Neuter) __________ X $ 65 / $ 40 = __________________
Paid by Cash __ Credit Card __ or Check #___________ Date Received: _______________
Yes
No
Yes or No
_
Check Box Below If Qualified for Low Income
Medicaid
Food Stamp
Senior Discount (65 or over)
Total Received = _____________________
Appointment Date:_______________________________ Veterinarian: Animal Clinic of Saint George or Washington Family Vet
Animal Clinic of Saint George – Dr. Ball (857 E. Tabernacle), 673-9696. ***No Food after midnight the night before appointment, a minimal amount of water is
okay. Have your pet to this Vet’s office between 8:30 AM – 9:30 AM. A pick up time will be discussed upon drop off. *NOTE: If your pet is 8 years or older,
you will be required to pay for a blood test before anesthesia can be administered ($72).
Washington Family Vet – Dr. King & Dr. Barton (969 N 3050 East B1 – A) 627-1300. This Vet’s office is located behind Albertson’s Grocery Store and before
Costco & Sportsman’s Warehouse. ***No food after 8 PM the night before the appointment, but water is okay. Have your pet to this Vets office between 7:00
AM - 8:30 AM. When you drop your family pet off for surgery a pick up time will be discussed. WILL NOT TAKE PETS UNDER 6 MONTHS.
*Fill out additional form if going to Washington Family Vet
Additional Information regarding your animal’s upcoming spay or neuter appointment:
***Please bring proof of vaccines with you to the Veterinarian’s office. If you do not have proof of vaccines the Vet will vaccinate your pet at an additional
charge (approx. $38-40 for dogs & $37-40 for cats). If your animal is in heat or pregnant we would prefer that you wait to have them spayed as this will be an
additional charge for you of $35 to $75 payable to the Vet. Animals 60 lbs. incur an additional charge of up to $30 and pets 100 lbs or over are charged more at
the Vets discretion. Pain or other medication if prescribed by the Veterinarian is also an additional charge of $21, for which you will be responsible to pay.
Other veterinary services can be quoted to you upon request. If you have any questions please contact PAWS at 688-9748 or the Veterinary Office.***
P.A.W.S. – Providing Animals with Support, Thanks You for being a responsible pet owner.