PACK Application for Assistance

P.A.C.K Application for Assistance

Thank you for reaching out! People for Animal Care & Kindness (P.A.C.K is a 501(c3) non-profit organization dedicated to promoting the welfare of animals by providing funds for veterinary care, food and supplies to animals in need.

It is important that you read and submit this application as soon as possible.

We will not be able to provide assistance until we receive this information from you, as well as your acknowledgment of our guidelines.

Please read and sign to acknowledge your understanding of the following:

PACK is unable to pay bills after services have been rendered. We are only able to provide assistance based on estimates for services that are needed in the future for the health and welfare of your pet (not to include routine care).
WE CANNOT GUARANTEE AN IMMEDIATE RESPONSE TO AN URGENT/EMERGENT SITUATION. We always strive to contact you as soon as we are able; however, if your pet is in critical danger, please seek help from your local emergency clinic.
We cannot move forward with a decision about whether or not we can provide veterinary assistance without a written estimate from your veterinarian. While we encourage you to seek funding on your own for an initial exam, if you are unable to get your pet in for an appointment, we may be able to help. Please let us know that you need to discuss options.
Any funds contributed to the care of your pet will be paid directly to the veterinarian or business providing services. Funds will never be given directly to the owner of the pet.
Depending on the medical need and the veterinarians recommendations, we may require sterilization of your pet if it is still intact.
While we would love to be able to help everyone who seeks our assistance, there is a limit to our funding. Therefore, we may need to have an honest conversation with you and your veterinarian about the long term prognosis for your pet, as well as the expectations for the level of care that may be necessary in the future. We simply cannot afford to provide care when there is not a reasonable hope for good quality of life for your pet.
Similarly, to ensure that we continue to have funds available for future animals seeking our help, we ask that you do your part in attempting to find funding to assist with your pet's needs: savings, credit card, Care Credit, Scratchpay, GoFundMe, Facebook fundraiser, etc. We have a handout with additional organizations that you may apply for assistance through - please ask if this would be useful to you.
P.A.C.K. may use photos of your animal and some medical case details (without personal information) for the use of fundraising, research and statistics.
By signing below, I am giving P.A.C.K. and it's representavies authorization to request and discuss my animals veterinary records and treatment plans.

I have read and understand the above guidelines:

Signature*

Date*

Date

Owner's Name

First NameLast Name

Phone Number

Email*

example@example.com

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Pet's Name*

Pet's Age*

Pet's Gender*

MaleFemale

Is your pet spayed/neutered?*

YesNoUnsure

Pet species and breed*

What food do you currently feed?

What do you need assistance with?*

Please provide a brief description of the current problem or need. If medical, provide more detailed information about the problem (Ex. vomiting, diarrhea, lethargy, injury, etc.) and length of time it's been happening:*

Has your pet already been seen for this condition?*

YesNoUnsureN/A

If yes, please provide name, location and phone of treating vet:

Are you considered low income? If so, please explain:*

What amount are you able to contribute to your pet's care?*

Have you reached out to other organizations for funding (please provide documentation if possible)? If so, which ones (ex. CareCredit, ScratchPay, CAPS)?*

Below is the option to upload any current documentation you can provide us such as a cost estimate for care. Also, please consider sending us photos of your pet, as we love to see who we're helping and it helps us to tell stories for future fundraising!

File Upload

Photo upload: