ACTS Canine Spay/Neuter Program Application

Please be as specific as possible.

(Approx.)

List specific markings...

You MUST submit at least one photo of the animal(s) on this form to apply for assistance...

Please write "None" if the animal does not have any medical issues.

If your pet currently has fleas or ticks he/she will have to receive a monthly treatment at the time of the procedure. The cost will be at your expense. [$10-$20]

If your dog does not have a current rabies vaccine he/she will have to be vaccinated at the time of surgery. The cost will be at your expense. [$12-$15]

Some of our Veterinarians require that your pet be vaccinated against kennel cough. If your dog does not have a current bordetella vaccine he/she will have to be vaccinated at the time of surgery. The cost will be at your expense. [$8-$10]

If approved ACTS requests that you make a donation to help cover the cost of the spay/neuter. The recommended donation is between $20-$120.

Humans :)

Please list their names and spay/neuter status.

1)The completion of this form does NOT guarantee that my dog will be awarded a voucher for the spay/neuter program at ACTS. 2)After I submit this form, it is my responsibility to call ACTS to review my application. (931)-266-7996 3)Once approved ACTS requests that you make a donation to help cover the cost of the spay/neuter. The recommended donation is between $20-$120. 4)If you are surrendering a litter of puppies ACTS will cover the spay and neuter of both parents. 5)If you are awarded a spay/neuter voucher it then becomes the owner's responsibility to book the spay or neuter appointment within 3 days at the veterinarian of our choice. You will receive the voucher via email.