Spay and Neuter Clinic Form October | Lucy Mackenzie Humane Society

Please fill out registration form and pay securely via PayPal. If you do not have a PayPal account, select the yellow PayPal button and choose Pay with Debit or Credit Card in the pop-up window.

Name
This field is for validation purposes and should be left unchanged.
Clinic Date: October 26, 2026 Please arrive between 8 – 8:30AM for check-in
Name(Required)
First Last
Email(Required)
Enter Email Confirm Email
Address(Required)
Street Address Address Line 2 City State ZIP / Postal Code
Cell Phone Number(Required)
Animal Name(Required)
Color(Required)
Species(Required)
Sex(Required)
Age (Please specify years or months)(Required)
Breed(Required)
If other, please specify
Animal History – Distemper Vaccination(Required)
Animal History – Rabies Vaccination(Required)
Copy of Rabies vaccination
Max. file size: 1 GB.
All animals must have proof of Rabies vaccination or receive the vaccination at the clinic.(Required)
I will bring proof of vaccination or will pay $15 for my animal to receive the rabies vaccination at the clinic
Has the animal ever been to a Veterinarian?(Required)
Where did you obtain your pet?(Required)
If other, please specify
Has this animal produced a previous litter?(Required)
If yes, how many litters?
Any health problems or previous surgery?(Required)
Procedures – Cat(Required)
Option
FVRCP Vaccine
Rabies Vaccine
Selamectin
Microchipping
Total
$0.00
This fee is NON-REFUNDABLE and is required to hold your spot for the clinic
Payment Method(Required)

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
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