• ALWAYS & FUREVER · ST. FRANCIS OUTREACH VETERINARY RESCUE COLLABORATION

  • Osawatomie Community Care

  • Monthly Community Care Drawing – Application for Veterinary Care

  • Always & Furever's Community Care Fund helps Osawatomie families afford veterinary care for the pets they love. Each month, a portion of our care is distributed by a fair, random drawing. Complete this form to enter. The application takes less than 3 minutes.
  • How it works
    • Applications open the 1st-20th of each month. Winners are drawn at random.
    • If you are not selected, you automatically roll into the next drawing for up to 3 months.
    • Each household may receive OCC services once per 12-month period.
    • No donation is required to receive services, and donations do not influence who is selected.

  • 2. Your information

  • Format: (000) 000-0000.

  • 3. Your pet

  • Always & Furever Midwest Animal Sanctuary alwaysandfurever.org
  • Page 1 of 3
  • ALWAYS & FUREVER · ST. FRANCIS OUTREACH VETERINARY RESCUE COLLABORATION

  • 4. What kind of care does your pet need?

  • Check the option that best describes your need (the medical team confirms the right care at the visit):
  • What kind of care does your pet need?*

  • Important – this is not an emergency clinic

    Our care hours are 8 a.m. to 5 p.m. If something urgent comes up and there's a way we can help within those hours, we'll do our best. This is not an emergency clinic – anything outside the program's scope must go to an ER vet, with no OCC fees applied. See "What OCC does not cover" on page 3.

  • 5. Proof of residency (required)

  • Attach a copy of ONE of the following showing your Osawatomie address:
  • Proof of residency options*
  • Browse Files
    Drag and drop files here
    Choose a file
    Cancelof

  • 6. Applicant agreement & signature

  • By signing below, I certify that the information above is true, that I meet the eligibility requirements in Section 1, and that I have read and accept the acknowledgements on page 3. I understand that entering the Community Care Drawing does not guarantee selection, that I will be asked to sign an informed consent form before any care is provided, and that if I am selected I must confirm within 72 hours or my slot may be offered to the next applicant. A no-show without notice may affect my future eligibility.
  • Date*
     - -
  • FOR OFFICE USE ONLY

  • Where to submit

  • Return this completed form with your proof of residency between the 1st and 20th of the month. Questions? Call us or visit alwaysandfurever.org.
  • Always & Furever Midwest Animal Sanctuary alwaysandfurever.org
  • Page 2 of 3
  • ALWAYS & FUREVER · ST. FRANCIS OUTREACH VETERINARY RESCUE COLLABORATION

  • What the OCC Program Covers

  • Please read this before applying so you know what to expect.

  • What OCC may help cover

    • Routine and wellness care (exams, vaccines, basic check-ups)
    • Spay and neuter surgery
    • Dental care
    • Common medical concerns within program scope (as confirmed by the medical team)
  • The medical team confirms the appropriate care at the time of the visit.

  • What OCC does NOT cover

    • 24/7 emergency services
    • Specialty referral services
    • Oncology
    • Long-term hospitalization
    • Rehabilitation
    • Elective procedures
    • Breeding-related care

  • Emergencies & program scope

  • This is not meant to be an emergency-services clinic. Our care hours are 8 a.m. to 5 p.m. If an urgent situation comes up during those hours and there is a way we can help within the program, we will do our very best. However, if a need falls outside the scope of the OCC / VRC program, you will need to take your pet to an emergency (ER) veterinary hospital. No OCC payments or fees will go toward that external care outside the VRC program.

  • Please acknowledge before applying

  • Initial each box to confirm you understand:
  • Always & Furever Midwest Animal Sanctuary alwaysandfurever.org
  • Page 3 of 3
  •  
  • Should be Empty: