top of page

Request for free or reduced copayment

Normally we will not process an application without a copayment. Most of the people using our program are low-income, so we try to keep the copay as low as possible. However, we do have a small fund that allows us to offer a limited number of reduced copayments. If you submit this request form, we will get back to you within a few days to let you know if you qualify for waived or reduced copay.


Note there could be additional charges due the day of surgery if your pet requires a rabies vaccine or has certain medical conditions such as pregnancy, heat or undescended testicles.

Please indicate which government assistance programs you are on.
Are you able to pay for rabies vaccination if required and/or other extra charges?
Yes
No
Tell us about your pets needing surgery
Female pets (check all that apply)
Male pets
For each pet needing surgery, tell us:

Pet #1

Species
Dog
Cat
Gender
Male
Female
Length of hair
Short
Medium
Long

Pet #2

Species
Dog
Cat
Gender
Male
Female
Length of hair
Short
Medium
Long

Pet #3

Species
Dog
Cat
Gender
Male
Female
Length of hair
Short
Medium
Long
bottom of page