SPCA Desexing Application

*	All information provided below is accurate. Please be aware if the forms are not filled in accurately we reserve the right to decline this application.
First Name *
Surname *
Mobile Number *
Email Address *
What is your full address? *
What city are you in? *
What is your dogs name? *
How old is your dog? *
What sex is your dog? *	Male Female
What colour is your dog? *	Black Black and Tan Black and White Blue Blue and White Brindle Brindle and Black Brindle and White Brown Brown and Black Brown and White Cream Ginger Ginger and White Golden Grey Grey and White Tan Tan and Black Tan and White Tricolour White White and Black White and Brindle White and Brown White and Tan
If your dog is female how many litters has she had?
What is your dogs approx weight? *
Does your dog have any health issues? *
Does your dog have any behavioural issues? i.e. vet anxiety, aggression *
Is your dog microchipped? *	NoYes
Would you like your dog to be microchipped? We will also register on NZCAR to you. *	NoYes
What breed(s) is your dog? *
How long have you had the dog? *
Where did you get the dog? If a rescue, please advise which one. *
Are you able to get your dog to the assigned vet should your application be successful? *
Tell us a little about your situation and how a free desexing will help you? *
Is there anything else you would like to add?
Please attach a clear photo of your dog? *
*	I understand I must listen to and follow the before and after care advised by the vet clinic and that any medication they might require at any post op appointment will have to be paid for by yourself.
I agree to the terms and conditions. * Link - https://service.sheltermanager.com/asmservice?account=cdrrnz&method=online_form_html&formid=31	NoYes