• Budkis Charbonneau Fund for Senior Urgent Pet Care

    Budkis Charbonneau Fund for Senior Urgent Pet Care

  • Client Qualification Form

  • Format: (000) 000-0000.
  • Throughout this form it is to be understood that the name "The Budkis Charbonneau Fund" may also be referrred to as The Budkis Fund or The Fund. The terms "emergency", "urgent", and "catastrophic" shall mean the following: unexpected, sudden, or a situation that requires prompt action. The term "emergency" does not necessarily mean after hours, ER or critical care. Due to the charitable nature of this orgnaization, The Budkis Fund reserves the right to run a confidential background and credit check on any person applying for assistance. At any time, The Budkis Fund may require additional proof of income before veterinary bills are paid. At no time does The Budkis Fund guarantee full veterinary payment. The Budkis Fund is designed to assiste in the payment of catastrophic, emergency, or urgent pet care for low-income senior citizens and is not obligated to pay 100% of veterinary fees. The person(s) applying for assistance, if approved, can only utilize The Fund one time for one pet in an 18-month period. Please be advised that due to the extremely high cost of ER and/or critical care, if the applicant must take their pet to any veterinary emergency or critical care facility, The Fund must heighten its discretionary judgment to protect its financial resources for the calendar year for other applicants. Therefore, the Fund may elect to pay no more than what is deemed reasonable by its Board of Directors for ER, after hours, or critical care. In addition to the general financial and support qualifications, it is understood that The Fund is not intended to support long-term or routine care issues including, but not limited to, the following: vaccines, flea producdts, ongoing medications, spay / neuter, ear cleaner, shampoos other than routine care. Rather, its purpose is to treat emergency or critical situations whereby the pet owner is unable to meet the financial requirements to have the recommended treat carried out. Based on other factors, it is at The Budkis Fund's sole discretion to approve or decline any donation. This This veterinary clnic is in no way affiliated with The Budkis Fund but does collect and share client and patient information with The Fund for their consideration.

    In consideration of the receipt of financial assistance from The Budkis Charbonneau Fund for my pet's veterinary care, and to show my appreciation for such assistance, I may choose to send to The Fund one or more photographs of my pet. If such photograph(s) include myself, as well as my pet, I give my permission to The Budkis Charbonneau Fund and to the Renton Regional Community Foundation to display such photograph(s) of my pet and me at fundraising events, in literature, and / or The Fund's website to carry out the mission of the Fund which is to assist pet owners with the costs of veterinary care.

  •  - -
  • Should be Empty: