Spay & Neuter Assistance Program

Please note that in accordance with our mission, we will give priority to breeds and mixes that are commonly subject to breed bans.

Please enable JavaScript in your browser to complete this form.

Name *

First

Last

Street Address *

City, State, & Zip Code *

Phone Number *

Email *

Household Annual Income *

• Under $25,000
• $25,000 – $49,999
• $50,000 – $74,999
• $75,000 – $99,999
• Other

What is your dog's name? *

What is your dog's age? *

What is your dog's sex? *

• Male
• Female

How much does your dog weigh? *

What is the assumed breed(s) of your dog? *

photo What the

What is the name of your veterinarian's office? *

I acknowledge that dogs age 10+ must have a wellness exam completed and be cleared with vet prior to acceptance into program. *

• Yes

I acknowledge that due to high demand, my spay/neuter appointment is expected to be completed within 30 days. *

• Yes

Upon completion of my application, I will email a photo of my dog to iowansagainstbsl@gmail.com for social media and fundraising purposes. *

• Yes

I acknowledge that Iowans Against Breed Bans is solely responsible for the cost of the spay/neuter surgery. *

• Yes

By submitting this form, I understand and agree that Iowans Against Breed Bans is not liable for any complications resulting from veterinarian-provided services through this assistance program. *

• Yes

Submit