HARBORS ASSOCATION OF VOLUNTEERS FOR ANIMALS (HAVA)
APPLICATION FOR LOW-INCOME SPAY NEUTER PROGRAM

Please complete this form and pay the copay fees. You will be contacted after a HAVA representative has reviewed your request. If you qualify, a voucher will be sent to you which you can use at any of HAVA's participating veterinarians. If you do not qualify, your money will be returned to you.

 

PLEASE COMPLETE ONE FORM PER PET.

 

COPAY FEES

Male Cat Neuter: $30
Female Cat Spay: $40

Female Dog Spay: less than 30lbs $50
Female Dog Spay: greater than 30lbs $60
Male Dog Neuter: less than 30lbs $40
Male Dog Neuter: greater than 30lbs $60

About You
About your Pet
Proof of Income

You may be requested to submit proof of income for all adults in your household.  The following documents may be used as proof:

Wage statement / Pay Stub Unemployement Statement
SSI/SSDI Statement L&I Statement 
Approval Letter for Cash Aid Approval Letter for food stamps
Approval Letter for DSHS Medical Coupons Alimony

 

Acknowledgement & Signature

Bissell pet foundation image and link

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