Rex's Legacy Spay/Neuter Program Application
RequiredRequired Question(s)
This program provides grants to qualified individuals to have their dog or cat spayed or neutered.  To qualify, applicants must be currently receiving benefits from the Ontario Disability Support Program.  Proof of qualification will be required.  

Applications will be accepted as long as funds are available.  One grant will be approved per family.  Please note that applications may not be approved; both the owner and the pet must qualify for the program to be approved.  
 
Required 1.
Please enter your contact information below.

First Name:
Last Name:
Home Phone:
Email Address:
emailaddress@xyz.com
Address 1:
City:
State/Province
(US/Canada):
Postal Code:

Required 2.
Are you currently using the Ontario Disability Support Program? 
Yes
No
Required 3.
Are you currently employed? 
Yes
No
Required 4.

Is your pet a dog or a cat?

Dog
Cat
Required 5.

What is your pet's name?

 

50 characters left.
Required 6.

How old is your pet?  If you're not sure, please estimate their age.

 

50 characters left.
Required 7.

Is your pet male or female?

Male
Female
8.

If your pet is a dog, what breed are they?  If you aren't sure please indicate "mixed breed" and an approximate weight.

 

50 characters left.
Required 9.
How long have you owned your pet?
 

50 characters left.
Required 10.

Does your pet have any injuries or health issues?  Do they take any medication?

 

350 characters left.
Required 11.

Does your pet have a regular veterinarian?

Yes
Yes, but they haven't been in a long time
No
Required 12.
Please list all veterinarians that you have taken your pet to in the past 2 years.  If you haven't taken them to a veterinarian, please indicate "none".
 

350 characters left.
Required 13.

If your application is approved, will you be able to bring your pet to the WECHS Veterinary Clinic for their surgery appointment?  Please note that pets must be dropped off at 8am and picked up the same day between 4 and 5pm.

Yes
No
  • Comment:

  • 500 characters left.
Thank you for applying!  You will be contacted within a week to let you know if your application has been approved.