SPAY & NEUTER APPLICATION

Before submitting your application, we recommend reviewing the Frequently Asked Questions (FAQ) page. For additional inquiries, please utilize our Facebook Messenger General Chat for prompt assistance.

Spay & Neuter Application

Services provided cover pet spay/neuter fees ONLY. The pet owner is responsible for any additional procedures, medical equipment, and/or medications.

OWNER'S FIRST & LAST NAME / NOMBRE Y APELLIDO

PET NAME/ NOMBRE DE SU MASCOTA

MALE/FEMALE - MASCULINO/FEMININO

MALE/MASCULINO - NEUTER

FEMALE/FEMENINO - SPAY

AGE/EDAD

WEIGHT/ PESO (LBS)

COLOR/COLORIDO

BREED/RAZA

NUMBER OF UNSTERILIZED/UNFIXED DOGS IN HOUSEHOLD / NÚMERO DE PERROS NO ESTERILIZADOS

CONTACT PHONE/ NUMERO DE CELULAR

EMAIL/CORREO ELECTRÓNICO

ADDRESS/DIRECCIÓN

CITY/CIUDAD

ZIP CODE/CÓDIGO POSTAL

Please upload your Proof of Residency.

Please upload a photo of your dog.

Liability Release

I understand that by signing this form I voluntarily authorize a veterinarian to spay/neuter my pet. I understand that surgical/other unknown risks are inherent with necessary pre-surgery medication, anesthesia and/or surgery; and release California Spay or the licensed veterinarian from any liability.

I UNDERSTAND THAT THIS IS A RELEASE FROM LIABILITY.

I sign this of my own free will.

Entiendo que al firmar este formulario voluntariamente autorizo a un veterinario a esterilizar o castrar a mi mascota.Entiendo que hay riesgos quirúrgicos o otros riesgos desconocidos al administrar la medicación necesaria antes de la cirugía, la anestesia y/o durante la cirugía; y libero a California Spay o al veterinario licenciado de cualquier responsabilidad.

ENTIENDO QUE ESTE ES UNA FORMULARIO DE LIBERACIÓN DE RESPONSABILIDAD.

Firmo esto por mi propia voluntad.

ELECTRONIC SIGNATURE/ FIRMA ELECTRONICA