Program Applications Listed below are digital and downloadable forms associated with some of our many Programs.
If you are interested in assistance through these programs, please download or fill out directly the appropriate form.
If downloaded; fill out, and email to info@fchs.org, mail, or drop off at our office located at 1786 North Market Street, Frederick, MD 21701 for processing.
For questions, please contact our office at (301) 694-8300
Wellcare & Shanklin We are currently not offering the Wellcare and Shanklin programs Effective April 20th 2025 until further notice.

Not In Use

Not In Use (Form Name)

Not In Use (Description)

Name
First Name
Last Name
Phone Number
Address
Street
Address line 2
City
Zip Code
Country
State
Email
Your Age
Number of people in your household
Proof of Income, pay stubs not accepted (select which you will upload)
Proof of Income Document Upload here, pay stubs not accepted.
Pet's Name
Species
Sex
Weight (approx.)
Age
Breed
Has your pet had all of its recommended shots?
What veterinarian will you use?
Name
First Name
Last Name
Name
First Name
Last Name

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Pet Overpopulation Prevention Program (POP)

Pet Overpopulation Prevention Program

The Frederick County Humane Society has partnered with local participating veterinarians to offer spay/neuter services at a reduced fee to Frederick County residents who qualify. Each household is permitted to process two pets through the program each year.

Name
First Name
Last Name
Address
Street
Address line 2
City
Zip Code
Country
State
Phone Number
Email
Number of people in your household
Total household gross income from all sources
To qualify for the program you must be a Frederick County resident who’s Total Annual Household Gross Income is within the Eligibility Guidelines. “Total Annual Household Income” includes income from all household members and sources. “Maximum Household Income” is determined by the number of household members:
What proof of income do you have, pay stubs not accepted.
Upload Proof of Income here
Pet Name
Species
Sex
Age
Breed
Which of our “Participating Veterinarians” will you be using?
Payment Method; The fee for spay/neuter surgery is: $25
For payment by credit card:
POP vouchers expire within 30 days of issuance.
Name
First Name
Last Name
Text field label
Text field label
Name
First Name
Last Name
Name
First Name
Last Name
Name
First Name
Last Name
Select option
Select option
Select option
Select option

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