Petstablished | Manage your Animal Welfare Organization (AWO) with our easy-to-use software.

You can save your current form progress and come back later.

Save Progress

Personal Information

* First name

* Last name

* Email

* Email confirmation

Home phone

Cell number

* Current Address

Current Address 2

* Zip

* City

* GenderMaleFemale

Country

*State/Province

Date of Birth

* Month

* Day

* Year

About Your Cat

This form is used to gather the information to have your cat spay/neutered on Thursday, December 12th Polk County Humane Society will be making a run to the Sedalia Spay & Neuter Clinic with 25 cats for spay/neuter services and vaccinations (optional). Please complete one form per cat that you'd like to send with us. Drop off at Polk County Humane Society in Bolivar is 7 a.m. and pick up is 6 p.m. Cats will have to be fasting (no water or food after 6 p.m. on Tuesday evening).

Cat's Name

Cat's Size

Your best estimate of the size of your cat.

Small (less than 5 lbs)Medium (5-8 lbs)Large (8-11 lbs)Extra Large (over 11 lbs)

Cat's Breed

Your best guess of your cat's breed

Domestic Short HairDomestic Medium HairDomestic Long HairAmerican BobtailMaine CoonPersianRagdollRussian BlueSiameseUnknownOther

Cat's Age

Your best guess of the age of this cat.

2-3 months old4-6 months old6-8 months old8-11 months old1 year old2 years old3 years old4 years old5 years oldOver 5 years old

Cat's Gender

MaleFemaleUnknown

Is this cat feral (wild)?

Yes (I CANNOT pick up this cat and will be trapping it)No (I CAN pick up this cat and put it in a carrier)Not sure (I'm not sure yet if I can pick up this cat or will have to trap it)

Primary Color of this Cat

BlackWhiteGray/BlueCalicoBrown or Gray TabbyYellow or Orange TabbyTuxedoTortoiseshellSiamese PointsOther

Is this cat anxious or does it have the potential to bite a person?

Yes (This cat might bite someone, be careful.)No (This cat is tame and won't bite anyone.)Not sure (I'm not sure if this cat will bite or not.)

Is this cat already current on it's rabies vaccine?

Yes, this cat is current on its rabies vaccine.No, this cat is NOT current on its rabies vaccine.I dont' know if this cat is current on its rabies vaccine or not

Services Requested

The primary purpose of this trip is to get female cats spayed. If we have spots available, we will also take male cats along for neuters. Additional vaccines are optional. Payment will be required upfront when your cat's spot is confirmed. We will send you a link for payment, or you can make payment by cash at the Humane Society.

Refunds will only be given in the case of cat illness or personal emergency.

You will be required to confine the cat the night before the surgery and withhold food and water after 6 p.m. on Wednesday evening, December 11th.

Services Requested

Cat Spay or Neuter - $25Rabies Vaccination - $15Basic/Combo Vaccination (FVRCP) - $20Ear Tip (feral cats only) - $0 (This is cutting off the tip of one ear to indicate that a feral cat is neutered or spayed)

Consent

I authorize the surgery and other services I have selected for this cat. I understand there are risks involved and hold the Sedalia Spay & Neuter Clinic and Polk County Humane Society harmless from liability for any adverse outcomes.

Yes

Signature

Please type your name below as your signature on this form:

I have read and agree to the terms and conditions. By checking this box I am confirming that I am 13 years of age or older.

You can save your current form progress and come back later.

Save Progress

Neuter/Spay Sign Up Form

Personal Information

About Your Cat

Services Requested

Consent