Community Medical Support Request Form
Cincinnati Animal CARE is a county shelter operating with limited resources, and we recognize that access to veterinary care can be a barrier for many in our community. To help bridge this gap, CARE offers limited low-cost veterinary services aimed at keeping pets with the families who love them. For needs beyond our capacity, we partner with other low-cost providers to help streamline access to care and ensure continuity of support.
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
What kind of animal are you seeking care for?
*
Dog
Cat
Other
Animal Name
*
Sex
*
Male
Female
Age Range
*
Unweaned - Bottle (0-3 weeks)
Unweaned - Gruel (3-8 weeks
Juvenile (8 weeks - 5 months)
Young Adult (6 months - 11 months)
Adult (1 year - 7 years)
Senior (8+ years)
Age
*
Animal Weight
*
Breed
*
What medical care is your pet in need of?
*
Dog Spay (female): $75.00
Dog Neuter (male): $50.00
Cat Spay (female): $60.00
Cat Neuter (male): $40.00
Physical Exam (illness): $30.00, please note that diagnostics and treatments are additional cost and will be based off of the findings from the exam.
Physical Exam (injury): $30.00, please note that diagnostics and treatments are additional cost and will be based off of the findings from the exam.
Other
Core vaccines that can be added to your appointment (see the above flyer)
*
DHPP (dog): Free
FVRCP (cat): Free
Dewormer (dog & cat): $5.00
Bordetella (dog): $5.00
Rabies (dog & cat): $10.00
Nexgard (dog): $20.00
Revolution (cat): $15.00
Microchip (dog & cat): $15.00
Other
Please share as much detail as possible about your primary concerns. For injuries or illnesses, be sure to include symptoms, when they first began, and whether they have improved, worsened, or changed over time.
*
Please upload all relevant veterinary records associated with this medical issue, including exam notes, test results, and treatment history.
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Photo of Animal
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Submit
Should be Empty: