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Trap Neuter Release Form

"*" indicates required fields

Once your application is approved, we will call you to schedule the surgeries.

Caregiver Name*

Date*

Address*

Street Address

Address Line 2

City

State

ZIP Code

Phone*

Email*

What is the TOTAL number of cats you need to have altered?*

What kind of shelter do the cats have?*

Location of cats if different from address above

Street Address

Address Line 2

City

State

ZIP Code

In requesting services for the TNR (Trap/Neuter/Return) program, through AllPets Animal Clinic, I understand and agree to the following (Please read and initial on each field below:

AllPets Animal Clinic TNR Program only provides spay/neuter for unowned and stray/feral cats. I certify to the best of my knowledge that the cats I am admitting for the program are unowned. I release AllPets Animal Clinic and its facilities from any liability incurred with transporting and before/after care of these cats.*

Please initial

These cats will have their ear tipped or notched and tattooed to identify them as altered, free roaming cats.*

Please initlal

Feral cats face risks during handling, anesthesia, and surgery and I hold AllPets Animal Clinic its facilities harmless should a cat experience complications, injury, escape, or death. Any cat deemed by the veterinarian to be severely ill or injured will be humanely euthanized. Best efforts will be made to contact me first. If I cannot be reached at the number given, AllPets Animal Clinic may go ahead and humanely euthanize if determined to have a condition making its release inhumane.*

Please initial

I understand that due to the limitations of the TNR program no other veterinary services will be provided. If a problem is identified by the veterinarian I will be informed of the condition at the time of release, and it will be my responsibility to seek veterinary attention elsewhere.*

Please initial

I agree to pay a minimum fee of $140 per cat*

Please initial

I promise that these cats will be safely sheltered after surgery. I will only release them once they are fully awake. I will return all cats to the location(s) from which they were taken following the guidelines established by AllPets Animal Clinic.*

Please initial

I agree to pick up the admitted cats at the specific time and adhere to the discharge and recovery instructions.*

Please initial

I agree to only bring cats in a humane trap or secure. I also agree to not bring multiple cats in a trap. I understand that I may be turned away on surgery day if I do not adhere to these requirements.*

Please initial

While we do not use antibiotics at the time of uncomplicated spay/neuter surgery, there are times when once an animal is anesthetized that we find an infection or wound that should be treated with antibiotics. If indicated by physical exam findings and instructed by the veterinarian, I agree to allow the administration of a single dose of long-acting antibiotic as appropriate. I understand that there will be an additional charge for this medication.*

Please initial

Signature below indicates agreement with all of the above statements.

Signature of Applicant*

Date*

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Phone

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