RSPCA Centrepay Dog Desexing Program Application

VIEW PARTICIPATING VET LIST

Please make an appointment with your nominated vet clinic, from the list of participating services. Upon approval from RSPCA Tasmania you will be informed, as will the vet. Should you not be successful, it is your responsibility to cancel the vet appointment.
Fill in the forms below.

DOWNLOAD APPLICATION FORM

This program is only available to holders of healthcare, pension and student cards. One loan at a time, for every card holder.
Upload an image of your Photo ID and Centrelink card, front and back to this form.
Clients who have defaulted on previous Centrepay contracts may not apply for this program.
Any fraudulent claims will be referred to Tasmania Police for investigation.

Dog Desexing Program

Step 1 of 2

Centrepay Desexing Voucher
Your Details
Name*
First Name Last Name
Phone*
Email*
Centrelink CRN*
What is a CRN?
Full Address
Your Pet's Details
Pet's Name
Breed
Age
Sex
- Male
- Female
Vet's Details
Veterinary Clinic*
Cost of Surgery*
Date of Surgery*
DD slash MM slash YYYY
Consent*
Consent*
Please tick this box to indicate that you understand that
a) if any complications occur, you will be liable for additional costs, i.e. if your dog is pregnant or in season, or your male dog has retained testicles; and
b) payment of your dog’s surgery fees will be capped at $500. You will be liable for additional charges.

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Centrepay Deduction Authority
I, of , phone No. and Centrelink No.
Date of Birth*
DD slash MM slash YYYY
authorise Services Australia to make a deduction of $25.00 each per fortnight from my
Centrelink Benefit Name*
and pay this amount to RSPCA Tasmania account 555 077 624H for dog desexing surgery commencing from the next pay cycle.
I request that the deduction of $25.00 continue until the target amount of $ is reached - up to a maximum total of $500
NOTE If a deduction has a target amount and the final deduction is set to pay less than $2, the second last deduction will be increased by up to $2 to cover the final amount.
Consent*
Consent*
I give permission for RSPCA Tasmania to disclose my information to Services Australia for the purposes of checking my account number, billing number and amount I want to pay, and reconciling my payment deduction details. I also give permission for RSPCA Tasmania to Services Australia my correct account and billing number if required. I understand that I can change or cancel my deduction at any time, and further information about Centrepay can be found online at humanservices.gov.au/centrepay.

By submitting this form, I agree to repay the debt as listed above. If payments are cancelled at any stage, an account will be issued for the remaining amount and I will incur a $20.00 (twenty dollar) account keeping fee.
Upload a Photo ID and Centrelink card, front and back*
Drop files here or
Accepted file types: jpg, gif, png, pdf, Max. file size: 20 MB, Max. files: 8.
Payment Method*
- I'd like to pay the $50 down payment now by credit card
Down Payment
Price:
Credit Card Payment
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
Name
This field is for validation purposes and should be left unchanged.

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Over the Xmas and New Year period, we are closing the dog and cat desex program.
We are closed from 23 December 2022 till 9 January 2023.