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Spay and Neuter Assistance Request form -

San Bernardino and Riverside County, California

Be Advised Hooks Home Bound Rescue does not issue Spay/Neuter Vouchers or give assistance at this time. We reach out to current programs that you may qualify for after review of your application. 


Assistance is issued at a limited basis. Each assistance program may have its own regulations that can be only used at veterinary offices that are associated with that program. 

(Please check with Hooks Home Bound Rescue for list of participating Veterinary Offices and programs.)



 Spay/Neuter Assistance Request Form

For

 San Bernardino County and Riverside County, California

Spay and Neuter Assistance request form
please provide your phone number so we may be able to contact you if there is any questions or concerns with your application!
I attest I currently live in:
Do you agree to the following:
I understand Hooks Home Bound Rescue is not associated with any Program that may assist you in your need.*
I understand that if issued assistance the funds/vouchers are issued on a limited basis. *
I understand that there is a limited number of vouchers/assistance issued per address per lifetime *
If issued a voucher i agree vouchers will be mailed to me in about 4-6 weeks if approved*
Pet information:
2nd pet information
Is there other pets in the home you are requesting assistance(you will need to fill in another application) for?*
I agree to fill in another application if I have more then 2 pets I am requesting vouchers for*
Legal
I authorize Hooks Home Bound Rescue to Forward my information to any organization that may issue vouchers or assistance in my area for this application*
I authorize each spay/neuter assistance program and Hooks Home Bound Rescue to contact me based on this application*
I understand my voucher may or may not be approved based on the following: home address, income, Senior status, and sometimes Breed of pet *
Due to increased no call no shows after setting appointments, You authorize Hooks Home Bound Rescue to charge you a $100 refundable deposit upon processing your application*
You understand that this program is a free program to you and is only available to you via sponsorship and donation of those that support us! If you would like to make a donation please click yes if not no *
By typing my name in the following signature box below I agree all information is true and correct to the best of my knowledge*
Application Submitted
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Thank you! Your application is being processed. We will contact you with-in 7(seven) business days to follow up on your application!

When Submitting your application please check the following:

Please be sure you review your application.

All Starred questions must be answered. If they are not answered you will receive an error and your application will not be received.

Errors on page have been seen as follows:

If nothing occurs after you hit submit button - Please scroll up and fill in all areas in Red!

If after submission you do not receive a check mark and any error message comes on your screen your application has not been submitted,

Please wait some time and try again.

If you receive an "Error occurred please try again" this is an automatic message that a required question is not answered. Please check all starred questions.

If you have received a check mark with a courtesy message you have made it to the tow line and your application has been submitted. 

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