Humane Advocacy Veterinary Assistance Program Questionnaire (Not Spay/Neuter)

  • Humane Advocacy Veterinary Assistance Program Questionnaire (Not Spay/Neuter)

  • All personal information provided on this form is kept confidential and will only be shared outside our organization when necessary to support you and your pet. In those cases, information will be shared solely with our trusted partner organizations involved in assisting your pet’s care.

  • Are you filling out this form to spay or neuter your pet?*

  • Our spay/neuter financial assistance is currently PAUSED. Please do not proceed with this form if you are looking for spay/neuter. Please email us at ha@eastbayspca.org if you need more information on spay/neuter at this time.

  • We help bridge the gap for pet owners who can’t afford full-cost veterinary care. We ask you to contribute what you can, so we can stretch our resources to help as many pets as possible. To qualify, you must:

    • Live in Alameda or Contra Costa County
    • Commit to spay/neuter your pet (financial assistance available)
    • Show proof you’ve owned your pet for at least 30 days (e.g., vaccination records, microchip info, or a time-stamped photo)
    • Follow all East Bay SPCA and Humane Advocacy rules

    Our program does not cover:

    • Emergencies
    • Chronic conditions requiring ongoing care
    • Conditions with a poor prognosis
    • Specialized treatments
    • Cosmetic care
    • Routine wellness

    Important notes:

    • Completing the questionnaire does not guarantee assistance
    • If we don’t hear from you within 2 weeks of contacting you, you’ll need to reapply

    We know how stressful it is when a pet is sick. East Bay SPCA and our veterinary partners are here to help. We treat everyone with respect and expect the same in return. Any abusive or disruptive behavior will result in loss of assistance.

  • General Information

  • Is your pet experiencing a medical emergency?*

  • Please note that we cannot guarantee immediate assistance for emergency situations. Due to high demand, it may take up to a week for us to respond to your questionnaire.

    The following are 24-hour emergency hospitals with available financial resources:


    Veterinary Emergency Group (VEG), 2431 San Ramon Valley Blvd, San Ramon, CA, 925-718-7771

    Veterinary Emergency Group (VEG), 622 Contra Costa Blvd Suite A, Pleasant Hill, CA, 925-384-2110

    OakVet Animal Specialty Hospital, 1133 7th St, Oakland, CA, 510-879-4888

    PETS Referral Center, 1048 University Ave, Berkeley, CA, 510-548-6684

    *Please Note: EBSPCA is not affiliated with any of these clinics. 

  • Is your pet ONLY in need of a check-up, vaccines, and/or a microchip?*

  • We currently do not provide assistance for low-cost general wellness and vaccinations, as there are many affordable options available in the area. Please refer to the following. Click on the name of the organization to be re-directed for more information. 

    • East Bay SPCA: schedule an appointment for wellness or vaccines online
    • PetVet/Petfood: Oakland (510) 652-9822; El Cerrito: (510) 215-5101
    • Cheap Shots (see clinic schedule here): You can text 510-565-8001  
    • Paw Fund in Berkeley
    • Joybound Clinic in Walnut Creek
    • Contra Costa Animal Services vaccine clinic; appointment needed
    • Project Pet pop up vaccine clinics
    • Furry Friends Pet Relief; appointment needed and can be booked on website 
    • VIP Pet Care; has a searchable database

  • Is your pet having problems with their teeth or mouth?*

  • If your pet is 10+ years old and has dental issues, we are unable to help at this time.

     

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  • Pet Species *
  • What county do you live in or spend most of your time?*

  • At this time, we can only provide funding for Alameda and Contra Costa County. 

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  • Is it okay if we text you about this application?*
  • Are you currently experiencing homelessness, living in a shelter or temporary housing?*

  • Before continuing with this application, please call Pets of the Homeless at 775-841-7463 to see if you can get a case manager. Doing this will increase available funding for your pet. 

  • What is your preferred language?*
  • In a typical month, what is the total income of the primary pet owner of this animal?*
  • And, how many people are also cared for using that income? *
  • Do any of the people who help pay for this pet receive assistance through social security/disability (SSI/SSDI) and/or government benefits for housing, food, health insurance, education, or otherwise (i.e. MediCal, TANF, SNAP)?*

  • Pet Details (This section is about your pet!)

    If you have multiple pets needing veterinary care, you must submit one form for each pet. 
  • Sex*
  • Spayed or Neutered?*

  • Please note: After your first appointment, you must commit to spaying or neutering your pet (financial assistance available) in order to receive any additional financial support.
     
     
     

  • Microchipped?*
  • Vaccinated?*
  • Has your pet already been to a vet for that problem?*
  • Do we have permission to contact this vet regarding your pet's condition?
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  • How does your pet act with new people or strangers?*
  • Where does your pet spend most of their time?*
  • Where did you get your pet from?*

  • Before proceeding to submit, stop here and submit your proof of ownership to us!

  • You need to provide proof of ownership that is at least 30 days old. You can upload any of the following:

    • Screenshot with time stamp of pet's photo from your phone
    • Active license with the city
    • Microchip registration
    • Vaccine records
    • Veterinary records
    • Adoption paperwork

    If you are having trouble uploading a photo, please email us at: HA@EastBaySPCA.org

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  • Final Section

  • We offer payment plans - would you be able to make regular monthly payments for vet care?*
  • How did you find out about Humane Advocacy?*
  • East Bay SPCA collects photos and quotes from pet owners who have utilized the Veterinary Assistance Program. These are used in promotional materials to support and help fundraise for our HA programs. Please select the appropriate box below if we can or cannot use your photo and name in our marketing materials:*

  • Program Terms

    • I confirm that all the information provided above is true and accurate to the best of my knowledge.
    • I understand that completing this questionnaire does not guarantee that I will receive assistance.
    • I understand that just because one request is approved does not mean future requests for help with this pet or any others will automatically be approved.
    • I understand that the Humane Advocacy team will reach out to me to further discuss this matter and may request additional documentation.
    • I understand that I will need to pay an exam fee for animals being seen at a veterinary clinic.
    • I understand that all appointments must be coordinated through the Humane Advocacy team.
    • I understand that due to high demand, it may take up to 10 business to receive a response.
       

  • Conclusion

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