Spay Neuter Assistance

STEPS IN THIS PROCESS

1. Review the qualifications below to ensure you are eligible for our Low-Income Assistance Program.
2. Submit an application for each pet needing to be fixed. (for example, two cats would require two applications)
3. Submit your proof of income in the online application or mail to:
   HAVA
   PO BOX 243
   Raymond, WA 98577
4. Pay HAVA the co-pay fee listed below. You will receive an email with a payment link once your application is approved.
5. You will be notified when approved, and HAVA will email you a voucher number.
6. Contact one of our approved vets to schedule the appointment.
7. The Spay/Neuter procedure is performed. The vet will bill HAVA for the procedure.
   HAVA does not cover any additional costs.

QUALIFICATIONS

This program is limited to pet owners who are financially unable to pay to spay or neuter their pet. You must meet the following household income qualifications to be eligible. You must submit your low-income documents in the online application or mail a copy to HAVA’s PO BOX. Our mailing address is PO BOX 243, Raymond, WA 98577. If you are unsure if you qualify, please call us at (360) 942-4716, and we will let you know.

ACCEPTABLE LOW-INCOME DOCUMENTATION:

• Wage Statement/Paycheck Stub
• SSI/SSDI Statement
• Approval Letter for Cash Aid
• Approval Letter for DSHS Medical Coupons
• Unemployment Statement
• L & I Statement
• Approval Letter for Food Stamps

PARTICIPATING VETERINARIANS:

Country Pet Vet: 300 Parpala Rd Naselle (360) 484-7228 (Cats only!)
Vetters Animal Hospital: 2400 Ocean Ave Raymond (360) 942-3440
Willapa Veterinary Services – Raymond: 230 Ocean Ave Raymond (360) 942-2321
Willapa Veterinary Services – Grayland: 2012 State Road 105 Grayland (360) 267-4444

COPAY FEES

Female cat spay: $90
Female dog (less than 30 lbs) spay: $120
Female dog (greater than 30 lbs) spay: $150

Male cat neuter: $60
Male dog (less than 30 lbs) neuter: $110
Male dog (greater than 30 lbs) neuter: $120

Please note: these copay fees are non-refundable. Once a voucher is issued, there is no way to cancel it. Vouchers expire six months after being issued. We recommend completing the spay/neuter process sooner than later.

PLEASE COMPLETE ONE FORM PER PET.

APPLICATION FOR LOW-INCOME SPAY NEUTER ASSISTANCE

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1About you

2About your pet

3Low-income Documents & Acknowledgement

Your Name *

First

Last

Are you over 18? *

• Yes
• No

Email *

Phone *

Mailing Address *

Address Line 1

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Different Physical Address

• My Mailing address and physical address are the same.

Physical Address *

Address Line 1

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Next

Is this animal YOUR pet? (You own it) *

• Yes
• No

Is the animal feral? *

• Yes
• No

Your pet's name *

Is it a cat or a dog? *

• Cat
• Dog

What is the gender? *

• Female
• Male

Providing inaccurate information to this question could result in your animal not being fixed on the day of their surgery!

Is she currently in heat or pregnant? *

• Yes
• No
• Unsure

Providing inaccurate information to this question could result in your animal not being fixed on the day of their surgery!

How old is your pet? *

Select your dog's weight range: *

• Less than 30 lbs
• Greater than 30 lbs

Breed and description: *

Please select one of the approved vets you will use: *--Select One--Vetters Animal HospitalWillapa Veterinary Services (Raymond or Grayland)Country Pet Vet

Please select one of the approved vets you will use: *--Select One--Vetters Animal HospitalWillapa Veterinary Services (Raymond or Grayland)

Do you already have an appointment for the procedure? *

• Yes
• No

When is the the appointment? *

Date

Time

Next

Number of people living in your household: *

Number of Adults with income in your household: *

Total Annual household income: *

Are you sure?

Submitting inaccurate information on this form may result in the request immediately being rejected. You should include all forms of income including assistance programs.

You will be required to submit evidence of low income to qualify for this program. Below are acceptable documents.

• Wage Statement/Paycheck Stub
• SSI/SSDI Statement
• Approval Letter for Cash Aid
• Approval Letter for DSHS Medical Coupons
• Unemployment Statement
• L & I Statement
• Approval Letter for Food Stamps

By submitting this application you certify all the information provided on this application is accurate.

Sign & Submit