Application for Assistance With Owned Pets

SPECIAL NOTICE AS OF APRIL 8, 2024: FIX’EM KC IS OUT OF FUNDING UNTIL FURTHER NOTICE. WE ARE NOT ACCEPTING SPAY/NEUTER APPLICATIONS AT THIS TIME. We will reinstate our service as soon as funds are raised and are sincerely sorry we cannot help you at this time.

Please reach out to low-cost spay/neuter clinics like PET RESOURCE CENTER (59th & Troost KCMO), NAWS (Gladstone MO) and HUMANE SOCIETY OF GREATER KC (KCKS).

Thank you.

Date

MM

DD

YYYY

Name of pet owner

First Name

Last Name

Home address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Email

Phone

(###)

###

####

Name of pet(s) for whom you need help

Have you received a citation from animal services?

Type of pet

Dog

Cat

Bird

Other

Pet's breed

Pet's weight

Pet's gender

Male

Female

Pet's age

Is pet current on vaccinations?

(Rabies, DA2PPV, FVRCP)

Does your pet have a microchip?

(And is it up to date? If not, please contact your microchip company to update your contact information)

Any health conditions or concerns?

(If so, what?)

How many pets are in your household?

How many pets are in your household are fixed?

Are you able and/or willing to pitch in at all on the vetting cost? If so, how much?

Are you currently employed? If not, are you on disability?

How did you hear about us?

"No Show" Appointments...

Because we value the relationships with our veterinary partners, pet owners MUST show up for scheduled appointments. It is costly and disruptive when scheduled appointments do not show up. If you cannot make a scheduled appointment for whatever reason, please let the clinic know immediately and reschedule the appointment. If you cannot show up for the second appointment, you’ll need to proceed without our assistance. Please type "YES" if you agree to this - Thank you.

Fix’em KC serves the Kansas City Metropolitan area including the counties of Jackson, Clay, Platte, and Cass in Missouri, and Johnson, Wyandotte, Leavenworth, and Miami in Kansas.

Application For Assistance With Owned Pets

Please complete the application below if you need assistance spaying, neutering or microchipping your dog, cat or other.

If you cannot make a scheduled appointment for whatever reason, please let the clinic know immediately and reschedule the appointment. If you cannot show up for the second appointment, you’ll need to proceed without our assistance.