Food and vet help form

About Pet assistance

We can temporarily provide needy pet families with:

■ a short term supply of food,

■ or other items (as available).

The above may be available as limited resources allow.

We also have access to low-cost pet vaccination and spay/neuter resources as well as pet care financing options.

Request for information on assistance with food and vet care
First name(Required)
Last name(Required)
Street address(Required)
City(Required)
Zip code(Required)
Email(Required)
Phone
I would like to receive information on(Required)
Information on getting pet food.
We have a limited supply of pet food on hand at the shelter. Please submit this food request and, if the pet food that you are looking for is currently available, a Pet Retention Specialist will contact you by either phone or email for a pick up date and time.
Species(Required)
Other, please fill in species
Food requested(Required)
admin food
Resolution/food
Follow up
Contact agent
Contact date
MM slash DD slash YYYY
Follow up comments
Follow up notes
Pick up date
MM slash DD slash YYYY
Pick up time

: Hours

Minutes

AM/PM
Outcome
Completed food requests
Help with veterinary care

To acquire financing for pet medical needs, click a link below to go to ScratchPay a program available at six participating area veterinarians. Should you choose this option, you will not need to submit this form.

ScratchPay Link

Veterinary services at a discounted rate are often available through the Pet Retention office. Please click Submit below to send us a request for information.
admin vet
Admin vet
Contact agent
Contact date
MM slash DD slash YYYY
Owner applied for financial assistance
Through what agency
Approved
Does the owner have a vet's diagnosis?
Summary of diagnosis
Call outcome
Admin notes
Appointment Date
MM slash DD slash YYYY
Time

: Hours

Minutes

AM/PM
Final vet assistance request outcome
Ticket closed
Other services
Please use the space below to describe what it is you are requesting.

One of our Pet retention Specialists will contact you either by phone or email to discuss your request.
Please enter your request here.
admin other
Other resolution
Contact date
MM slash DD slash YYYY
Contact agent
Notes
Other outcome
Name
This field is for validation purposes and should be left unchanged.

Request for information on assistance with food and vet care

Information on getting pet food.

We have a limited supply of pet food on hand at the shelter. Please submit this food request and, if the pet food that you are looking for is currently available, a Pet Retention Specialist will contact you by either phone or email for a pick up date and time.

Resolution/food

Help with veterinary care

To acquire financing for pet medical needs, click a link below to go to ScratchPay a program available at six participating area veterinarians. Should you choose this option, you will not need to submit this form.

ScratchPay Link

Veterinary services at a discounted rate are often available through the Pet Retention office. Please click Submit below to send us a request for information.

Admin vet

Other services

Please use the space below to describe what it is you are requesting.

One of our Pet retention Specialists will contact you either by phone or email to discuss your request.

Other resolution