**Co-pay of $40 includes annual vaccinations, rabies, pain medication, ear cleaning, & nail trimming. Rabies vaccinations are required for all dogs and cats entering the clinic unless proof of current vaccine is presented. No additional charges unless there are add-ons or complications.

**6% Kentucky state sales tax is added to all services.

**If you are approved, you will be invoiced for your co-pay when your pet gets on the schedule. Your pet will not be seen if you do not pay your co-pay before the clinic fills up. Clinics fill up fast. Please pay upon receipt.

**You will be emailed instructions for drop-off after payment. Watch your emails!

**Do not complete this application if you want to register cats. Use the Community Cats page to register cats; it is free to all and is not based on income. This assistance is for dogs only.

**Limit of 2 dogs per household at this time.

Name *

First Name

Last Name

Phone *

(###)

###

####

Email *

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Do you own or rent? *

Own

Rent

If you rent, are pets allowed? *

Yes

Total adults & children in your household? *

Total household income per month? *

This amount should include pensions, social security, child support, or any other source of income.

Please check all of the public assistance programs in which you participate. *

Food Stamps

Medicaid

Federal Supplemental Security Income (SSI)

Aid to Families with Dependent Children

Rental Assistance

Fuel Assistance

Social Security

Women, Infants, and Children (WIC)

Unemployment Benefits

None

How many dogs do you have that need spayed or neutered & their sex? *

Be specific, we sometimes have cancelations and knowing what sex helps us get them in faster!

Is your pet up to date on the following shots? *

5 in 1 DHPP (distemper, hepatitis, adenovirus cough, parainfluenza, and parvovirus)

6 in 1 DHLPP (everything above plus leptospirosis)

Rabies

None

I hereby attest that the information above is true and correct to the best of my knowledge. *

Yes

I understand that there is a $40 co-pay due before my pet can be seen. *

Yes

I understand that I will be removed from the list if I do not pay my co-pay or if I fail to show up for my appointment.

Our goal is to help as many people as we can. No shows and unpaid co-pays will result in your application being moved to the end of the waiting list. If you have any questions or issues with payment please email us at gatewayareahumane@gmail.com. Thank you!

Yes

Your application has been submitted. Clinics are only scheduled as the vet’s schedule allows so there may be some wait time. If you have any questions you can email GatewayAreaHumane@gmail.com

Gateway Area Humane Society
Gatewayareahumane@gmail.com

P.O. Box 123
Mt. Sterling, Kentucky 40353

Physical Location
309 Flint Drive
Mt. Sterling, Kentucky, 40353

Phone: 859-404-4497
(leave a message, the phone is not monitored at all times)

We are a volunteer ran non-profit. All donations go directly to helping animals who need assistance! We appreciate any and all donations!

Donate Here!