On-Line Spay/Neuter Application Form (revised November 2017)

If you have a limited income and need financial help with spaying or neutering your pet, Olympic Mountain Pet Pals will provide assistance as long as funds are available. OMPP is a non-profit organization funded by local donations and grants, serving Jefferson County residents only.

For pet spay/neuter information call (360) 385-7263.
Help with feral cats, call (360) 437-9085.

INFO: Puppies and kittens must be 8 weeks old, weigh over 2 pounds, and be weaned. Mother dogs and cats must have their litters weaned, plus another week's delay before surgery. Dogs and cats can be spayed while in heat but there is a greater risk of complication. NO FLEAS PLEASE! The vet may charge you for flea treatment.

Information about owner:

First Name (required):
Last Name (required):

Email (required)

Best Phone Number to Reach You (required)

Other Phone

Mailing Address (required)
Street

City , WA, Zip

Participating vets:
CVVH Chimacum Valley Veterinary Hospital (360-385-4488) 820 Chimacum Rd, Port Hadlock.
HVC Hadlock Veterinary Clinic (360-385-2020) 842 Ness Corner Rd, Port Hadlock.
OBAH Oak Bay Animal Hospital (360-385-7297) 745 Oak Bay Rd, Port Hadlock. Cats only, must be over 4 months old.

Please choose your vet.

Please fill in all information about each animal to be spayed or neutered:

Name of Pet: Dog/Cat Sex:
Weight: Age:
Reproductive status: Description (breed, color):

Name of Pet: Dog/Cat Sex:
Weight: Age:
Reproductive status: Description (breed, color):

Name of Pet: Dog/Cat Sex:
Weight: Age:
Reproductive status: Description (breed, color):

Income Affidavit:
I certify that I am a resident of Jefferson County,
that my gross monthly income is $
and supports people.

Will you consider a co-pay?
 I am unable to contribute to the cost of surgery at this time So that OMPP can help more pet owners, I will co-pay the vet at the time of appointment this amount: $

If your application is approved, we will send a payment voucher to the vet you selected and call or email you to give you instructions as to how to arrange your appointment with the vet. If you do not hear from us within a week of applying, please call 360-385-7263. Ideally, the pet's owner should bring the pet to the appointment to authorize the procedures to be done. If that is not possible, the owner should sign a note authorizing the surgery to be presented to the clinic by the person transporting the pet.

OMPP does not pay for pre-anesthesia testing or shots. No cosmetic or other procedures (such as de-clawing, tail docking, or ear cropping) may be done during financially assisted spay or neuter surgery.

By checking this box, you affirm that all the information supplied above is correct. This is required and is equivalent to your signature.