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Get Cortland Spca 2010-2024

Cortland Community SPCA 879 McLean Rd. Cortland NY 13045 Shelter Office 753-9386 Clinic Coordinator 344-0014 Incomplete Applications will not be processed - Feel free to use back of form to supply additional information Applicant Information Name Cell Phone Email Home Phone Work Phone Current Address Town County Age Postal Code Animal Information Dog Male Dog Weight Breed Color Cat Female How long have you had pet How did you acquire your pet Has your pet ever had a litter Yes Do you have other unaltered animals Yes Name of Vet No If so how many Last seen Is your pet in heat Is so please explain Date of Rabies Vac Proof Date of Parvo/distemper Other Please explain any medical info we need to know Emergency Contact In case of emergency how may we best reach you Financial Information of adults in home of children in home Do you qualify for public assistance in any way Yes No If yes please circle all that apply SS Disability Medicare Medicaid HEAP Foodstamps WIC Things you Need to Know -The CCSPCA reserves the right to refuse service or reschedule appointments on an as needed basis. -Further financial assistance may be available for those that qualify. Further financial documentation is needed to consider a client for our deeper discount please inquire before you make your appointment if interested* What YOU are responsible for -Bringing animal and picking animal up ON TIME we will give you a specific appointment time for both Gross Monthly Household Income before taxes -Provide proof of rabies and distemper/parvo vaccinations. IF PROOF IS NOT PROVIDED YOU WILL BE RESPONSIBLE TO PAY CLINIC FOR VACCINES AT 10. 00 EACH. -Payment is to be made in full at time animal is being picked up* No exceptions. -Clients PLEASE GIVE 72 Hour Notice for cancellation of change of appointment. Clinic Fees Out of County Clients are scheduled on an As Need basis with an additional 25. 00 charge There is an extra 10. 00 charge for any dogs weighing over 65 pounds. Rabies and distemper/parvo vaccinations given are 10. 00 each. is 8. 00 MALE CAT 45. 00 FEMALE CAT 60. 00 Signature of Applicant MALE DOG 80. 00 FEMALE DOG 95. -Further financial assistance may be available for those that qualify. Further financial documentation is needed to consider a client for our deeper discount please inquire before you make your appointment if interested* What YOU are responsible for -Bringing animal and picking animal up ON TIME we will give you a specific appointment time for both Gross Monthly Household Income before taxes -Provide proof of rabies and distemper/parvo vaccinations. IF PROOF IS NOT PROVIDED YOU WILL BE RESPONSIBLE TO PAY CLINIC FOR VACCINES AT 10. 00 EACH. -Payment is to be made in full at time animal is being picked up* No exceptions. IF PROOF IS NOT PROVIDED YOU WILL BE RESPONSIBLE TO PAY CLINIC FOR VACCINES AT 10. 00 EACH. -Payment is to be made in full at time animal is being picked up* No exceptions. -Clients PLEASE GIVE 72 Hour Notice for cancellation of change of appointment. Clinic Fees Out of County Clients are scheduled on an As Need basis with an additional 25.

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