DCES Dog Blood Donor Program

DCES Pet Blood Donor Program

Dog Donor Application
To see if your dog qualifies to be enrolled in our lifesaving program, fill out the questionnaire below. If all the requirements below are met, expect an email from our team within 2 - 3 business days to arrange a detailed phone call about the program and its screening process, ensuring your pet is a perfect match.
Date

MonthDayYear
Date
Owner's Name

First NameLast Name
Employee Name (for DCES employees only)

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Dog's Name
Is your dog between 1.5 and 8 years old, meeting our program's age requirement?
What is your dog's estimated current age?
Is your dog 50 pounds or heavier, meeting our program's weight requirement?
What is your dog's estimated current weight?
Additionally, please ensure your dog meets the following requirements. If so, put a check mark next to each applicable criterion:
For Cat Owners
Is your dog between 1.5 and 10 years old, meeting our program's age requirement?
What is your pet's estimated current age?
Is your cat 8 pounds or heavier, meeting our program's weight requirement?
What is your pet's estimated current weight?
Additionally, please ensure your pet meets the following requirements. If so, put a check mark next to each applicable criterion:
How did you hear about the program?

Other
If you were referred to the program by an employee who works at Dogs and Cats ER & Specialty, please provide their name below:
Should be Empty:

DCES Pet Blood Donor Program

For Cat Owners