Clinic/Services Request Form

Our waitlist for spay/neuter is currently closed. Due to the high demand and long wait, we have temporarily paused adding new animals to the waitlist. We encourage anyone looking for spay/neuter services to check out these other options. We will reopen the spay/neuter waitlist once we are caught up with the current backlog of requests. Please continue to use this form to submit requests for wellness services and pet surrender. Someone from Leech Lake Legacy will respond to you by phone, text or email to confirm wellness appointments and surrender requests.

First Name
Last Name
Home Phone #
Mobile Phone #
Email
Mailing Address
Street Address
City
State
Zip
Do you live on the Leech Lake Reservation?
Are you a Leech Lake band member?
Pet Name
Pet Species (cat, dog, etc.)
Pet Breed
Pet Age
Pet Color/Markings
Is your pet spayed or neutered?
Pet Gender (Male or Female)
Has your pet had any litters? If so, how many and when?
Pet Weight
Has your pet previously received vaccines?
If previously vaccinated, what did they receive and when?
Did Leech Lake Legacy provide the vaccines?
Pet Description & Health Concerns
Which services are you interested in? (Check all that apply)
- Wellness only
- Surrender
Services through Leech Lake Legacy are for residents of the Leech Lake Reservation or enrolled band members only. Due to high demand, our waitlist is currently quite long, it will take several months to get a call for an appointment.