CONTACT INFORMATION:

Please provide information about the cat(s) you would like to have spayed/neutered:

In addition to this application, you are required to provide documentation of eligibility. These documents need to be submitted with your application.

By submitting this form, I acknowledge that I have read and agree to abide by the instructions, requirements, and conditions. I am requesting the sterilization of my dog(s) described above and understand that there will be no charge for the spay or neuter service unless I am a no call/no show for the appointed time. I understand that if I do not show up for the appointment, I will be charged a $20.00 fee before being allowed to reschedule the free spay/neuter (as someone else could have had that appointment). I understand that all medical procedures carry a degree of risk, although it is very small for sterilization surgery. and cannot hold the Brevard Humane Society liable for any unexpected outcomes. This information is true and correct to the best of my knowledge.