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Application for Financial Assistance
*
Date
Name of Veterinarian or Veterinary Hospital
*
Email
*
Patient Name
*
First
Last
Canine or Feline?
*
Canine
Feline
Male or Female?
*
Male
Female
Sterilized or not?
*
Sterilized
Non-Sterilized
Breed of Patient
*
Birthdate or Age of Patient
*
Medical Condition
*
This finacial assistance is provided to the above veterinary hospital on behalf of the patient designated above. The assistance to each client is limited to one occasion per calendar year.
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Medical situations that a grant may be awarded for:
Pyometra
Urocystotomy
Cat bite abscess
Soft tissue wound
Upper respiratory infection
Orthopedic surgery
Mass removal surgeries
Severe dental disease