Registration Form

Spay/USA is currently experiencing a higher volume of requests than normal. Our current turnaround time can be up to 72 hours.

PRIVACY POLICY: Information given to SPAY/USA is confidential, and will not be shared with any individuals or organizations. We will not sell or rent the information you provide online to third parties.

If you live outside the above listed areas, please complete the following form to be referred to a low-cost clinic in your area:

First Name: 
Last Name: 
Address: 
City: 
State:  Zip Code: 

Area Code: 

Daytime Phone: 


County: (e.g. Jefferson County)


E-Mail Address: (case sensitive)


Re-enter
E-mail address


DOGS # of animals to be spayed/neutered

Approx. Age(s) If known

 Approx. Weight
Male Dog(s)

under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.

up to 20 lbs.

21 - 50 lbs.

over 50 lbs.
Female Dog(s)

under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.
CATS # of animals to be spayed/neutered Click below if  gender unknown Pet Tame Stray Feral/ Wild 

Approx. Age(s) If known

 Approx. Weight
Male Cat(s)

Unknown
under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. over 5 yrs.
over 2 lbs.

over 2 lbs.
Female Cat(s)

Unknown
under 6 mo. 1 yr. - 5 yrs.
6 mo. - 1 yr. under 5 yrs.

under 2 lbs.

over 2 lbs.

Do you receive any of the following forms of public assistance?
Unemployment Social Security Income Other
Medicaid Disability  

How did you hear about us?
(Check all that apply)

Surfing the web Referred by vet or program Telephone Book
Pet Store Humane Group Radio PSA
Flyer Fund Raising Mailing Television PSA
SPAY DAY USA North Shore Animal League America Unknown
Heloise Newspaper Article Other
Friend/Relative Used SPAY/USA Before

If you have any additional questions when you get our reply, call us at 1-800-248-7729.
Due to the heavy volume of inquiries submitted, follow-up emails will not be answered.