To help ensure that our limited resources go to those who most need our help, please apply only if you are in genuine need of our services. Thank you.
Spay Baton Rouge is just one of the low-cost spay/neuter options available in this area; to learn about others, please click
here
.
Official Spay Baton Rouge Application
A * Denotes a Required Field.
Contact Information
First Name*
Last Name*
Email*
Confirm Email*
Street*
City*
Postal Code/Zip*
Parish*
Choose:
Ascension
East Baton Rouge
East Feliciana
Livingston
Other
West Baton Rouge
West Feliciana
Home Phone*
Cell Phone
Other Phone
Animal Information
How many animals do you need to get fixed?*
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Current Veterinarian*
Have you checked with your vet for a price quote on this surgery?*
Choose:
Yes
No
If yes, the price was?
Financial Information
What amount of money can you afford PER ANIMAL for the spay/neuter surgery? We suggest a minimum of $35 per cat or $75 per dog.*
Would you like to make an additional donation?*
Total annual income:* - NOTE: Do not enter commas or periods.
How many people in your household?*
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Number of people that income supports*
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Please indicate any financial assistance you currently receive by checking ALL applicable boxes:*
(At check-in, you will be asked to verify your responses below by presenting the applicable card(s) together with a valid ID.)
Medicaid
Louisiana Purchase Card
LaChip card
Other Public Assistance (describe below)
**
**If you checked "Other Public Assistance" or if you have other information that will help explain your need for our services, please describe in the box below:
Additional Information
Please indicate whether the animal(s) for which you are applying is/are purebred.*
Choose:
\
Yes
No
If you answered “Yes”, please describe how you acquired your purebred pet(s). If you qualify for our services, you will need to provide this same information in writing to the veterinary clinic at check-in.
How many fertile animals will remain in your household once the animal(s) in this application is/are spayed/neutered?*
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How did you hear about this program?*
Form Submission
Please click the “Submit Application” button only ONCE to avoid sending duplicates. Your application will be processed, but it may take a few moments. A copy of the application will be sent immediately to the email address provided. Thank you!
IMPORTANT: To make sure you don’t miss our reply, please check your “Junk” email folder or better yet, add Spay Baton Rouge [*@spaybatonrouge.org] to your address book or safe list!
By clicking “Submit Application”, I certify that all information I have provided on this application is true and accurate to the best of my knowledge. I understand that if I knowingly provide false or inaccurate information and as a result receive Spay Baton Rouge services for which I would not otherwise have qualified, Spay Baton Rouge may at its discretion seek reimbursement from me for the fair market value of those services, and/or disqualify me from receiving future assistance.