JAZZPURR SOCIETY

REQUEST FOR SPAY/NEUTER SERVICE


Please return this form, the copy of THE WINDSOR STAR advertisement plus the $50 bond to

Jazzpurr Society for Animal Protection

Suite 205, 647 Ouellette Ave

Windsor, ON N9A 4J4

Tentative Day of Surgery: _____________________ Confirmation Date: ________________________


In order to hold your surgical appointment, please make certain that all documents have been received by us before the confirmation date. Thank You.


Name:


 

Address:


 

City/Town: ____________________________ Postal Code:


 

Home Phone: ______________________ Work Phone: ____________________ Fax:      


 

Description of Cat:

JSAP ID: ________________________ Sex: ____ Age: _______ Size: ______ Breed:


 

Description:


 

Condition:


 

Ownership:

I warranty that to the best of my knowledge the above cat is a stray or feral animal and is not legally owned by anyone. I have placed an advertisement in the “Lost and Found” column of THE WINDSOR STAR and no one has responded to claim this cat. I hereby surrender this cat to the “ownership” of Jazzpurr Society for the purposes of this procedure.

Condition:

To the best of my knowledge the cat is healthy and not pregnant

Custody Bond:

I am providing a $50 bond to Jazzpurr Cat Care Society (cash, cheque or validated credit card voucher) while the cat is in the custody of the above. This will be returned when the cat is picked up. Failure to pick the cat up on the designated discharge morning will result in the charging of a $10/day boarding fee.

Post-Care:

I hereby agree:

       1.      To pick the cat up from Jazzpurr Society immediately after recovery from surgery.

       2.      To provide foster care: food and shelter for the cat for the rest of its life or until a JSAP approved adoptive home is found for the cat(s).

       3.      To actively cooperate with Jazzpurr Society in the care of this cat for its lifetime or until a suitable adoptive home is secured.

       4.      To actively protect the cat from harm. Under no circumstances is the cat to be taken or given to anyone who may cause harm, injury or death to the cat (including the Windsor/Essex Humane Society).

Financial Need:

I hereby attest that my financial situation is such that this procedure could not be performed without the assistance of Jazzpurr Society’s program.

Waiver:

I understand that the above cat will be neutered, vaccinated, ear-tipped and given further treatment as determined solely by JSAP and absolve Jazzpurr Society, Clearwater Animal Hospital and all agents thereof of all liability and claims relative to the above cat(s) and procedures. I understand that if, in the sole discretion of the veterinarian, this cat is found to be pregnant, or so unhealthy as to preclude safe surgery, the procedure will not be performed; furthermore, if the health status of the cat is found to be morbidly poor, euthanasia may be performed.

 

Signed:


 

Date: _________________________________



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