SNAP

Subsidized Spay/Neuter Application For Low-income Calgarians

SNAP is a charitable program with limited resources for qualified low income Calgarians. Proof of income may be requested.

* De-notes required fields.

Cat Owner Information:
*First Name:	*Last Name:
*Address: (No PO Boxes please)	*Name of your community i.e. Dover:
City: Quadrant:	*Postal Code:
*Home/cell phone:() -	*Email address: (No email? - provide the email of a friend or family member)
*Approximate household income per year: $0 to $19,999 $20,000 to $29,999 $30,000 to $39,999 $40,000 to $49,999 $50,000 to $59,999 $60,000 to $69,999
*How many adults in your home work:
How many people in your household: Adults (18 or older) Children (Under 18 of age)
*How many cats do you need fixed (max 10):

Alternate or Emergency Contact: This information is needed in the event that your cat is lost at some point in the future and you can't be found. Please provide someone with a DIFFERENT NAME & PHONE NUMBER as an alternate.
*First Name:	*Last Name:
*Home/cell phone: ( ) -

SURGERY AGREEMENT AND WAIVER

I, being responsible for the cat(s) described above, have the authority to grant the veterinarian, the SNAP Program and their representatives, my consent to receive, treat and/or operate on these cat(s).
I understand that while all procedures are to be done to the best abilities of the staff, no assurance or guarantee has been made of the results of any surgery or treatment, and that risks and probabilities of complications exist in any surgical or medical treatment. I consent to the administration of anesthetics and/or other medications as may be deemed necessary by the veterinarian.
I understand that as the registered owner, I am responsible for following the veterinary clinic's pre and post surgery instructions exactly as required.
I will not hold the organizations that make up the SNAP Program and the SNAP volunteers, nor the attending veterinarians and their staff responsible should my cat contract any disease whatsoever.

In order to qualify for a financial subsidy to have your cat(s) spayed or neutered through the SNAP Program, you must be the Registered Owner of the cat(s) listed in this application.

I AM AT LEAST 18 YEARS OF AGE AND AFTER CAREFULLY READING THE ABOVE, I HAVE SIGNED IN AGREEMENT.

*Registered Cat Owner Name:
*Date:	*Owner Phone:() -

Important Information - Please print and read

The authorization to the veterinary clinic is valid for 30 days after issue.
Your appointment is ONLY for the spay and neuter surgery and identification. Other veterinary services require a separate appointment and you are responsible for those costs.
Before applying, kittens must be a minimum of 8 to 10 weeks of age, healthy and 2 lbs in weight.
Application for nursing mother cats can be made 2 to 4 weeks after the kittens are weaned.
As the registered owner you are responsible for calling and booking the appointment at the clinic.
Veterinary clinics require a 48 hour cancellation notice or your authorization will be invalidated and not re-issued.
As the registered owner you are responsible for the cat's transportation to and from the clinic.
As the registered owner, you must pay the agreed upon fee in full at the time you deliver the cat to the clinic for the surgery appointment.