Canine Spay and Neuter Form
Please complete form if you wish to make an appointment/or have made an appointment to have your pet spayed or neutered by the La Plata County Humane Society (LPCHS).
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  • Owner Information:

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  • Person to contact if you cannot be reached:

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  • SERVICE TO BE PROVIDED:

  • Vaccination Requests:

  • LIABILITY WAIVER:

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  • LPCHS uses qualified staff and approved materials for all procedures performed. It is important for you to understand that the risk of injury or death is always present. Carefully read and understand the following before signing your name.

    Acting as guardian of the pet named above, I hereby authorize authorize LPCHS, through veterinarians designated by LPCHS, to perform an operation for sexual sterilization.