Event Voucher | Flying B Rescue

Event Date

Your Information

First name

Last name

Address

City

State

Zip Code

Phone

Annual Household Income

Are you currently receiving Disability, Medicaid, SNAP, or TANF benefits?

Yes

Pet Information

Pet Name

Species

Dog

Cat

Community Cat (ear will be tipped during surgery)

Sex

Female

Male

Weight

Breed

Color

Age

Proof of rabies vaccination

Yes

Microchipped? Your pet will be microchipped if not already. This does not apply to community cats.

Yes

General Animal Requirements:

Patients must be older than 8 weeks and/or 2 pounds.
Patients must be less than 6 years old unless an "Against Medical Advisement" form is signed or pre-anesthetic bloodwork is performed.
Patients must be under 100 pounds OR be able to comfortably fit inside the mobile cages.
If a female dog/cat has recently had a litter, the young must be weaned.
Proof of rabies vaccination within the last year is required. Please bring a rabies certificate to check in (a rabies tag is NOT sufficient) or a vaccination will be required at surgery.
Pets should not have any food after midnight the night before.
Cats should be brought in a hard sided carrier lined with something absorbent. Dogs need to be brought on a leash, or in your arms (for smaller pets).

I understand that the voucher is good only for the event date above and my co-pay is non-refundable if I miss my appointment.

I understand that this voucher only covers the spay/neuter surgery, rabies vaccination, microchip, and an e-collar/cone for dogs. All additional fees are the owner's responsibility, including any upcharges for your animal being pregnant, in heat, cryptochordic, additional vaccinations, or other services. Flying B Rescue may cover additional fees on case-by-case basis.

I understand that accepting a voucher(s) through this program releases Flying B Animal Rescue & Sanctuary of all liability arising from any unforeseen events resulting from any of the procedures performed, up to and including the death of the animal.

Signature

FLYING B ANIMAL
RESCUE & SANCTUARY

SPAY/NEUTER EVENT
VOUCHER APPLICATION
please submit one form per animal

Your Information

Pet Information

FLYING B ANIMAL RESCUE & SANCTUARY

SPAY/NEUTER EVENT VOUCHER APPLICATION please submit one form per animal

Your Information

Pet Information

FLYING B ANIMAL
RESCUE & SANCTUARY

SPAY/NEUTER EVENT
VOUCHER APPLICATION
please submit one form per animal