Female Dog Application

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

Click Here to Upload

Providing proof of income is REQUIRED in order to be placed on the wait list to get your pet fixed. If you are unable to upload an attachment, you are required to email cmpdacc.clinic@cmpd.org within 72 hours.

If we do not receive your proof, your application will be declined.

Home Phone Number

Work Phone Number

Cell Phone Number

Owner's Birthdate

Month

Day

Year

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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)

Is your female dog in heat?

Yes

Is your female dog pregnant? (Our veterinarian will need to know prior to surgery if your dog is pregnant or may be pregnant)

Yes

Is your female dog lactating? (nursing babies)

Yes

If Yes- age of puppies

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?