May 2026 Apps Your First Name * Your Last Name * Email * Phone * PERMISSION TO CONTACT & PRIVACY POLICY * By checking this box, you agree to receive emails, phone calls and text messages from Good Dogma and Safe Haven ABC Clinic regarding your appointment. Message and data rates may apply. Reply HELP for help and STOP to opt out. No mobile information will be shared with third parties/affiliates for marketing/promotional purposes. Address * Address Address Address City City State/Province AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State/Province Zip/Postal Zip/Postal PROOF OF RESIDENCE – You must upload documentation showing that you reside at the address above. This can be your driver’s license, utility bill, etc. It must show your name and the address you provided above. Files accepted include jpg, jpeg, png, gif, heic, or pdf. * Drop a file here or click to upload Choose File Maximum file size: 10MB YOUR PET’S NAME * IS YOUR PET A CAT OR DOG? * Cat Dog IS YOUR PET MALE OR FEMALE? * Male Female Your Pet’s Weight (pounds) * How old is your pet? (years or months) * What is your pet’s primary breed? * Your Pet’s Primary Color * Your Pet’s Secondary Color * PET PHOTO – You must upload a photo of your pet. Files accepted include jpg, jpeg, png, gif, heic, or pdf. * Drop a file here or click to upload Choose File Maximum file size: 10MB Is your pet anxious or have potential to bite? * Yes No If yes, please explain: * Funding for this program is lilmited. Why should we select your pet to receive a $20 spay or neuter? * Notes – anything else you’d like for us to know? PET OWNERSHIP REQUIRED * I attest that this is my owned pet and not a foster, feral or anyone else’s pet. PET TRANSPORTATION REQUIRED * If my pet is selected to participate, I understand that I will be required to provide transportation of my pet to and from its appointment at Safe Haven ABC Clinic in Midwest City, OK. $20 NON-REFUNDABLE FEE REQUIRED * If my pet is selected to participate, I understand that I will be required to pay a $20 non-refundable fee to Good Dogma. ADDITIONAL SERVICES ARE MY EXPENSE * I understand additional services and expenses are my responsibility. Good Dogma is only covering the cost to spay or neuter my pet. I will pay for additional services at the clinic when dropping off my pet for the appointment. Link opens in a new tab/window. (Don’t forget to come back and finish this application form.) If you are human, leave this field blank.
