For the Love of Zeus
Address: 1301 Betty Jane Lane Amelia, Ohio 45102 Telephone: 513-256-5125 www.FortheloveofZeus.org
Financial Assistance Application
What type of assistance are you applying for?
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SAR Certification
Seizure Medication
Other Medical Assistance
Cremation
Other
Name
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First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Eligibility for assistance for our program:
In order to qualify for financial assistance through our program, documentations are required. Please provide the following information:
Annual Income
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Are there any special circumstances you have for seeking financial help? (In the event you do not qualify for the our program, we may still be able to help if you are experiencing hardship, so please list any circumstances which make it difficult for you to afford vet care for your pet)
Documentation Requests
We need the proper documentation to determine if you qualify for the financial assistance program. You can upload those files here if they are available online to you. If you cannot upload them, you can mail them to us at 1301 Betty Jane Lane Amelia, OH 45102 OR email to 4theloveZeus@gmail.com. Documentation must be received in order to qualify! We will respond promptly, but depending of the request please allow 24-hours or more for a decision.
K9 SAR Certification Course Information & Invoice
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Proof of Veterinary Medical Documents & Invoice
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Proof of Death & either Invoice or location for cremation
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Thank you for filling out the form! Please sign below in order to complete your application. By signing below, you attest that all information provided is true and accurate to the best of your knowledge.
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Date
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Month
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Day
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