Forms Portal

Spay/Neuter Application

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Pet Information

Please complete this information for each pet. You can add additional pets by clicking on the "Add New Entry" link. 

If you pet is current on their vaccinations, please answer "Yes" in the vaccinated column. If they are missing a vaccination or you are not sure, please answer "No". 

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Type
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Name
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Breed/Description
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Sex
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Age
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Weight
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Vaccinated

After you submit this form, our volunteers will review your application and confirm that you qualify for our program. You may be contacted to clarify your information. While waiting to have a voucher issued, we recommend that you get your pet up-to-date on all of their vaccinations. Most veterinarians require that animals are current on their vaccinations before they will complete the spay/neuter procedure. A list of low-cost vaccination clinics can be found on our website.

Once you receive a voucher, it is your responsibility to contact the veterinary office of your choice to schedule an appointment. It is important to discuss the final cost of the procedure with your vet of choice before confirming your appointment. The voucher is issued for the portion of the procedure that Lincoln Animal Ambassadors will pay for - this is not the price you will pay!

The appointment must be scheduled before expiration date listed on the voucher. The surgery does not need to be completed before the expiration date. It is also your responsibility to take your pet to the veterinarians’ office for their appointment.

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Financial Information

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To automatically qualify for financial assistance, you can provide one of the following:

1. Currently receiving WIC – upload your Statement of qualifying benefit period

2. Currently receiving Medicaid – upload the applicants Statement of qualifying benefit period. Medicaid documentation must be for head of household or applicant, not dependent children.

3. Current receiving Food Stamps (SNAP) – upload your Statement of qualifying benefit period

 

If you do not have any of the above, you must supply the following in order to be considered for financial assistance.

1. Valid Proof of identity – State issued photo id/driver’s license, a federal, state or local government, or military ID card.

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2. Proof of income – Earned and unearned (gross) income for all persons residing in the home. (Gross income is what you have before taxes or anything is taken out. You can show “earned income” with your paycheck stubs for the past month. “Unearned” income is money you get that is not a pay check. This could be child support or unemployment compensation benefits or disability benefits that you get.

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3. If you are self-employed, you must show a copy of last year’s income tax return.

We strictly follow Income Eligibility Guidelines to determine if someone is eligible for assistance.

See the income chart          .

Applicants can upload your financial verification documents with this application using the browse option below. Please include a description of the documents provided.

You can submit your application without providing these documents. You will receive instructions for providing these documents later in the confirmation email.

Documents can also be mailed to:

               Lincoln Animal Ambassadors
               ATTN: Spay/Neuter Program
               P.O. Box 67072
               Lincoln, NE 68506