Cat Spay Day Form

Cat Spay Day

Yorkton Animal Health Centre is happy to provide a LOW COST CAT SPAY program this 2019 summer in our area. Hopefully, with our efforts we will be able to impact the number of animals entering shelters and rescue organizations. Spay days will be held during specific days in the summer on July 16, 23, and 23. (Pre-book, spaces are limited) Location: Yorkton Animal Health Centre. Please fill out the form below to be included. Closer to the date we will contact you with additional information.

Client/Patient Information
Date*
Client's Name*
First Last
Spouse's Name
First Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code
Phone*
Work Phone
Cell Phone
Emergency Phone Number for Surgery Day*
Best contact number should there be an emergency with your cat during surgery.
Email*
Preferred Method of Communication for Reminders*
All Fees Are Due At The Time Services Are Rendered
Please Indicate Your Choice Of Payment*
How did you become aware of our spay clinic?
Pet's Information
Pet's Name*
First
Breed*
ie. domestic short/medium/long hair, siamese, sphynx etc.
Date of Birth*
Colour*
Sex*
Last Vaccinations*
*Rabies vaccination will be given if not up to date at no charge. If your cat is up to date on Rabies, proof of vaccination will be required.
Do you want any additional vaccinations for Upper Respiratory Disease (FVRCP, $20) or Feline Leukemia (FeLV, $20)?*
If your cat has no previous vaccinations, they will require a booster for the 2 vaccinations in a months time
Previous Vet Clinic
Does your pet have any allergies or is it on any medications? If so what?*
Any Notes about your pet: Wild/Feral, aggressive etc. tame, house cat etc.
Has she had kittens? If so when?*
Could she be pregnant? If so how far along is she?*

Cat Spay Day

Client/Patient Information

All Fees Are Due At The Time Services Are Rendered

Pet's Information