CITY OF LOS ANGELES
DEPARTMENT OF ANIMAL SERVICES
www.laanimalservices.com

SPAY & NEUTER VOUCHER APPLICATION
DISCOUNT SPAY & NEUTER COUPON PROGRAM

Residents are limited to a total of three (3) Spay & Neuter Certificates or Coupons per species (dog, cat, or rabbit).

Applicant Information
 
First Name is required
First Name* 
Last Name* 
Last Name is required
Residency*  I reside in the city of Los Angeles
I am homeless and reside on (cross streets):
Address* 
City* 
Zip Code* 
Phone Number* 
Please enter phone number in the format: (123) 456-7890
Email Address* 
A valid email address is required
Confirm Email* 
Email addresses do not match
Identification Type* 
Identification Type is required
Identification No.* 
Identification Number is required
ID Expiration Date* 
(MM/DD/YYYY)  
ID Expiration Date must be a valid date (MM/DD/YYYY) and ID cannot be expired
Annual Income* 
Income Source* 
(if any) 
Family Members* 
(including yourself) 

Animal Information
Animal Type* 
Animal Type is required
Animal Breed* 
Animal Breed is required
Animal Color* 
Animal Color is required
Animal Age* 
Animal Age is required
Animal Sex* 
Animal Sex is required
Animal Name* 
Animal Name is required









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