Portsmouth Pets: Spay/Neuter Assistance
PLEASE REVIEW THE INFORMATION BELOW BEFORE COMPLETING THIS FORM

Who should complete this form? --- Portsmouth residents who need financial assistance with the costs of spay/neuter for their pets (dogs, cats). Please complete one form per pet.

Why is so much information required? --- We need information about you and your pets in order to schedule appointments with our clinic partners. We also need information for our funding partner, the Prince William Humane Society's Homeless Animals Support Network, who provided the grant that helps us assist Portsmouth residents and their pets.

* Grant funding covers the costs of spay/neuter surgeries and related charges (e.g., female in heat). Funding also covers Rabies vaccinations, which are required by law.
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First Name *
Last Name *
Email Address *
Reminder: Email responses will be from spayhr2010@gmail.com or arttnr@gmail.com. CHECK YOUR SPAM/JUNK FOLDER FOR REPLIES.
Phone Number *
Alternate Phone Number
Street Address *
Zip Code *
Best way to reach you? *
Pet's Name *
Type of Animal *
If your pet is a dog, do you have proof of a current negative heartworm test?
Proof of a current negative heartworm test may be required by our clinic partners. If you do not have proof of a current negative HW test for your dog, bloodwork to ensure surgery is safe may be required and will be included with overall spay/neuter costs.
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Sex *
If your pet is female, is she pregnant or in heat?
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Age (SPECIFIY MONTHS OR YEARS) *
Approximate Weight (in pounds) *
Breed and color *
If your pet has any known health issues, please describe them here.
Please complete all of the questions above before moving to the final section of the form.
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