Community Veterinary Outreach Request
Our Veterinary Outreach program assists those who are experiencing homelessness or in transitional housing with preventative veterinary care for their pets. Requests must be made by caseworkers from partner social service agencies. We are not a public veterinarian, and cannot take clients outside of these parameters.
Client Name
*
First Name
Last Name
Client phone(s) *if applicable*
Client e-mail address *if applicable*
What organization do you work with?
*
Caseworker Name
*
First Name
Last Name
Caseworker Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Caseworker Email
*
example@example.com
What location are you requesting a visit?
*
Kitchener Waterloo Humane Society
Stratford Perth Humane Society
What is the best way to contact the client?
If by phone, would you prefer a call or a text?
Call
Text
Both
What type of animal(s) is your client requesting services for
*
Dog
Cat
Both
Approximate age of animal
*
Puppy/Kitten under 6 months
Adult
Senior
Unknown
Does the animal have a previous vaccine history?
*
Yes
No
Unknown vaccine status
Has the animal seen a veterinarian within the last year?
*
Yes
No
Unknown
If so, which veterinary clinic can we contact to get records transferred to us?
Please give us a description of the services your client requires
*
Wellness Exam
Nail Trim
Vaccines
Spay/Neuter
Health Concern *describe below*
Please describe any concerns or options not listed above
While this program is not designed to accommodate emergency requests, if your concern is urgent, please contact us directly for additional resources.
If you do not qualify for the program, or require urgent assistance, please contact our Community Outreach Coordinator, Stacy Murphy, RVT, for additional resources. 519-745-5615 x276 or stacy.murphy@kwpshumane.ca
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