Community Outreach Help Request Form

First and Last Name

Address

Phone Number

Please list all of your animals, their names, and their ages.

Do your animals primarily live inside or outside?

We offer help with getting dogs up to date on their vaccines, medical needs, and/or proper housing. We do require that you allow us to spay/neuter your dogs in order to receive any care support from us. Do you accept these terms? Yes or no.

Do you agree to provide follow up care (administering medicine, changing wound pads, etc.) as needed and instructed by the veterinarian?

Please list what support you need for each of your animals (vaccines, medical help, basic care and food, spay/neuter, or if other, please explain). Please note, we are not a food bank or shelter - we raise community funds to help meet the needs of the animals in our community who are most in need.

We require that all animals we support are also spayed/neutered. If your animals are not fixed, we will work with you to get them scheduled to be fixed and cover the associated costs. Please confirm if your animals are already fixed. If they are not, are you comfortable with us moving forward with getting them fixed?

Can you provide medical records for your current animals. If you can't, this does not exclude you from receiving help. This just helps the vet see what has been done so they can provide appropriate care.

Our greatest wish is to help every animal live their happiest and healthiest life, but we may have to prioritize cases due to funding. Please help us understand why you are requesting help and your current situation.