FRM SpayNeut Application

Application for Low Cost Spay or Neuter Program

Items marked with * are required

Owners Information
Owners Name *
Owners Name
Mailing Address (If different from Physical Street Address)
Mailing Address (If different from Physical Street Address)
Home Phone *
Home Phone
Cell Phone *
Cell Phone
Are you able to receive and print an Approval File online? *
Do you prefer to receive a mailed copy of the approval? *
Pet Information
Type of animal *
Pet's Sex *
Is your pet's rabies vaccination current? *
Please Respond to all the following statements. Failure to answer any will result in the application's disapproval.
Both my pet and I are residents of Duplin County. *
I will allow up to two weeks to receive the Surgery Approval and I will not schedule the procedure until I have a printed copy of it in my possession. *
I will sign the Surgery Approval prior to the procedure. *
I understand that the Low Cost Spay/Neuter Program is limited to dogs and cats only. *
I understand that the reduced cost is for a routine spay/neuter surgery only. There may be additional costs which is my responsibility to negotiate with the vet. *
I understand that a current rabies vaccination is required. If my pet does not have a current rabies vaccination, I will pay an additional cost for the vaccination on the day of the procedure. *
I understand that each Vet has different requirements so I will check with my Vet before selecting the Vet, e.g. a money deposit or new patient fee. *
I understand that I can only have one pet spay/neuter surgery for this request. *