Sterilization Form

"*" indicates required fields

General informations

First name*

Name*

Street number*

Street*

Apartment number

City*

We offer sterilization service only in the cities that are listed here. If your city does not appear there, you are not entitled to the service.

ZIP Code*

Phone*

Email*

Check one of the following 2 options:*

Social assistance recipient (please bring your social assistance card to your appointment)

Low income (we will validate your income level and eligibility before your appointment)

Combien de personnes habitent cette adresse? (enfant à charge inclus)*

Quel est votre revenu brut par année (avant impôt et déductions) ?*

Pet's infos

Species (Our sterilization program is only offered to cats.)*

Cat

How many cats do you want to sterilize?*

Name of the 1st animal*

Breed*

Age*

Cat's sex:*

color:

License number (if available)

Does your animal have any known pain or health problems?

Is it difficult to manipulate ?

Name of the 2nd animal*

Age*

Breed*

Cat's sex:*

color:

License number (if available)

Does your animal have any known pain or health problems?

Is it difficult to manipulate ?

Name of the 3rd animal*

Age*

Breed*

Cat's sex:*

color:

License number (if available)

Does your animal have any known pain or health problems?

Is it difficult to manipulate ?

What are the next steps ?
– The waiting time can vary from 1 week to 3 weeks. – You must therefore plan your budget based on your registration date;
– If you are a social assistance recipient, we will communicate with you via email. – Make sure we have the right information to reach you;
– If you are unable to keep your appointment, you are responsible for contacting us if you want another date;

Please note that boarding costs will be added if the animal is not collected on the date agreed with the Proanima employee.

Thank you very much for your cooperation.

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Date

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