Male Dog Application

Are you on any government assistance?

Yes

If yes: Upload proof of income or EBT card, FNS, SNAP, WIC, CHIP, Veterans Pension

Click Here to Upload

If you are unable to submit your application due to difficulty attaching proof of income, please email CMPDACC.Clinic@cmpd.org for assistance. You will not be able to submit an application without the proof.

We will be reaching out to you via email so please be sure to check your email daily.

Home Phone Number

Work Phone Number

Cell Phone Number

Owner's Birthdate

Month

Day

Year

Only Speak Spanish?

Haga clic aquí si solo habla español

Dog's Name

Pets must be between 4 months and 7 year BIRTHDAY for the Veterinarian to perform the surgery.

If your pet is PAST their 7 year birthday, you will be required to obtain surgerical blood tests from a veterinarian service. With out these tests, we will not be able to spay or neuter or pet.

Dog's Birthday or Estimated Age

Dog's Color

What breed does your dog look like? We need a specific type of breed; mix or "terrier/shepherd/etc" will not be accepted.

Dog's Weight(best guess)

If both testicles have not descended into the scrotal sac your pet may require multiple incisions, additional surgery time and extended recovery time. The Veterinarian must be informed prior to surgery.

YES - Both testicles have descended

NO - Only one testicle has descended

NO - Both testicles are internal

If you have an electronic version the current rabies certificate for this pet you can upload here.

Click Here to Upload

Anything else we should know?