Paws 4 A Cure - Applying For Assistance

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If an outside website brought you here, you must start at our Ask For Help page to read our policies and procedures before you complete the online application below. Press HERE to begin.

Paws 4 A Cure does not store any data about our website visitors in a cookie that would identify them, locate them, and determine their preferences or their financial activity.

DO NOT COMPLETE THE BELOW APPLICATION FOR ASSISTANCE IF YOU DO NOT HAVE YOUR DOCUMENTATION READY TO BE EMAILED OR FAXED.

Application For Financial Assistance

Paws 4 A Cure does not store any data about our website visitors in a cookie that would identify them, locate them, and determine their preferences or their financial activity.

* I have ALL of my required documentation for myself and for all members of my household that are over 18 years of age ready to be emailed or faxed TODAY and I have already provided my treating veterinary practice with the Veterinary Packet. If not, STOP HERE. Please have everything ready BEFORE applying for assistance.

* I understand that if my dog or cat does not have a treating veterinarian that diagnosed my dog or cat and has a treatment plan in place, my application will be automatically denied. STOP HERE

* By continuing, I acknowledge that I have read and agree to Paws 4 A Cure's guidelines, policies and procedures. I understand that Paws 4 A Cure CANNOT assist with charges incurred prior to approval of application. I understand that Paws 4 A Cure does not pay for routine veterinary care. This includes spaying/neutering, vaccinations, routine dental care, routine office visits and euthanasia. I understand that I should not rely on a grant from Paws 4 A Cure only. I have or will apply to several different financial assistance programs along with applying to Paws 4 A Cure, links to which can be found on the Helpful Resources page. I agree to complete the application process by providing your required documentation to prove hardship to grants@paws4acure.org. A list of acceptable documents can be found on the Ask For Help page along with your Applicant Packet. You agree to provide the Veterinary Packet that can be found on the Ask For Help page to your dog or cat's treating veterinarian.

Please do not fill out the online application if you are not going to follow through with the application process. Every application needs our attention, by you not submitting in your documentation, it takes us away from those that do. If your required documentation is not received within 72 hours of your online application being submitted, your application will move from pending status to closed status and you will have to re-apply for assistance.

** Required Fields - If you do not complete the required fields on the application that have an * next to them, your application cannot be processed. Incomplete applications will be automatically denied. **

Please turn OFF your CAPS LOCK before filling out the application for assistance below.

YOUR INFORMATION

* Your FULL Name

* Your Date of Birth

* Your Street Address

* Your City

* Your State

* Your Zip Code

* Your Email Address

* Confirm Your Email Address: *REQUIRED

* Your Contact Phone #

If your dog or cat does not have a diagnosis and treatment plan, STOP HERE. Please visit your veterinary clinic for your veterinarian to provide you with a diagnosis and treatment plan. After you have your diagnosis and treatment come back here and apply for assistance if you meet the qualifications on the Ask For Help page and have all of your required documentation ready to be sent in via email or fax.

* Your Employer Name

* Your MONTHLY net income

* Your Marital Status:

Your Spouse/Domestic Partner's First and Last Name

Spouse/Domestic Partner's Date of Birth

Spouse/Domestic Partner's Employer

Spouse/Domestic Partner's total MONTHLY net income

* Your Living Situation

* How many adults (over 18 years of age) are in your home?

* How many children (under 18 years of age) are in your home?

* NAME, RELATIONSHIP and BIRTH DATE of EVERYONE living in the home. Examples: John Smith (roommate) 07/17/1967 or Jane Smith (daughter) 05/23/2011. Do not include yourself.

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* Is your total household income normally above poverty level?

Yes
No

* Do you own or rent your home

* Monthly Rent/Mortgage

* Please select the statement that applies to your normal financial situation

Other please explain

Please check all that apply to your current financial situation:

I receive child support
I receive alimony
I receive a monthly inheritance
I receive unemployment benefits
I receive disability payments
I receive Social Security
I receive public assistance (welfare, food stamps, etc.)

Unemployment benefits amount received monthly

Child support amount received monthly

Alimony amount received monthly

Disability benefit amount received monthly

Social Security benefit amount received monthly

Public assistance received monthly

* Who pays for the household expenses?

* Please explain why you cannot afford the veterinary care. (Not about your dog/cat's veterinary care, you will answer about your dog/cat's needs later.)

How did you hear about Paws 4 A Cure?

* How many animals are in your home?

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Do NOT put more than one furchild on your application. If multiple furchildren are in need of assistance, you must complete a new application for each dog or cat in need of veterinary care.

* About The Dog/Cat

Dog
Cat

* Dog/Cat's Name

Dog Breed (if a dog)

* Age

* Sex

Male
Female

* My dog is a trained service animal.

Yes
No

A service animal is any dog that is individually trained to do work or perform tasks for the benefit of an individual with a disability, including a physical, sensory, psychiatric, intellectual, or other mental disability. Other species of animals, whether wild or domestic, trained or untrained, are not considered service animals.

* What is the date that you adopted/received your furchild?

* Is your furchild spayed or neutered?

Spayed (female)
Neutered (male)
Not spayed or neutered

* Is you dog/cat injured or ill?

Illness
Injury

* What is the date that the illness or injury started?

* Please explain your pet's illness or injury.

* Please provide your dog or cat's diagnosis (you MUST have a diagnosis from veterinary office). This is not a yes or no question, you must provide us with the diagnosis.

* Please explain the treatment received so far and the initial onset of the illness or injury.

* Please explain the treatment still needed. (As a reminder: Paws 4 A Cure CANNOT assist with charges incurred prior to approval of application and receipt by the veterinarian of the Acceptance Letter.)

* What is the estimated cost of the proposed treatment? (Your veterinary practice must provide an estimate for services still needed.)

* What amount are you able to contribute towards your pet's veterinary care?

* What amount are you asking for Paws 4 A Cure's help? (maximum grant is $500)

* Have you applied for CareCredit? (required)

Yes
No

* Amount approved from Care Credit

* Have you applied to Scratchpay?

Yes
No

* Amount approved from Scratchpay?

* Is the dog/cat receiving financial assistance from any other organization?

Yes
No

* Please list all of the organizations that you have applied to so far. A list of organizations can be found on our Helpful Resources page. Please do not rely on a grant from Paws 4 A Cure, you need to apply to many organizations. DO NOT PUT GoFundMe, CareCredit and ScratchPay since they are not organizations.

* Please list organizations that have approved your application for assistance AND amount you have been granted.

Please provide the link to your GoFundMe page

Please provide any other fundraising page link that you have

* Explain in detail how have you been trying to raise money for your dog/cat's veterinary care.

Pet Insurance Company Name

Policy #

Contact #

VETERINARIAN INFORMATION

You must have a treating veterinary practice.

* Treating Veterinarian's Name

* Veterinary Practice's Name

* Veterinary Practice's Address

* City

* State

* Zip Code

* Phone Number

Fax Number

Veterinary Practice's Email Address

Please be advised that your application will be immediately denied if you did not read and accept the User Agreement at the top of the application, if you do not complete the required fields with a * next to them or the drop down menus are not used. Please scroll up to review your application for financial assistance to ensure that ALL required fields have been completed.

* I understand that Paws 4 A Cure CANNOT assist with charges incurred prior to approval of application.

* I understand that Paws 4 A Cure CANNOT pay for diagnostics (testing).

* I understand that my online application will not be responded to until all of my required documentation is received by Paws 4 A Cure.

* I understand that Paws 4 A Cure does not pay for routine veterinary care. This includes spaying/neutering, vaccinations, routine dental care, routine office visits and euthanasia.

* I'm not actually reading this, I am just checking the boxes. If you actually read that, do not check the box. If you have checked this box off, your application is invalid and automatically denied. This is here to ensure that each person is actually reading our policies and procedures and not just checking boxes off to get through the application.

* I understand that IF I am approved, I am REQUIRED to fundraise by sharing the fundraising page that Paws 4 A Cure creates with my friends, family and local news media to generate donations for my dog or cat's veterinary care. The funds raised will allow Paws 4 A Cure to continue helping those in need. I understand that I must provide Paws 4 A Cure the contact information for the news media that you reached out to. I also must provide the links to the online news media articles. I understand that if I do not fundraise for my dog or cat veterinary care, Paws 4 A Cure will not send payment to the veterinary practice.

* I certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me for a grant. I understand that my application will be immediately denied if I did not completed the required fields throughout the application or the drop down menus are not used. I have scrolled up to review my application for financial assistance to ensure that ALL required fields have been completed.

IF YOU ARE NOT GOING TO SEND YOUR PROOF OF HARDSHIP DOCUMENTATION PLEASE DO NOT CLICK SUBMIT.

You will receive an email acknowledgement within 24 hours of receipt of your required documentation. If not received, please check your spam folder. Every application that has sent their required documentation is responded to. If the email response is not in your spam folder then your email server has blocked the email, please email grants@paws4acure.org

If your required documentation is not received within 72 hours, your application will move from pending status to closed status and you will have to reapply for assistance.

Please provide the attached Veterinary Packet to the treating veterinarian or direct them to the Veterinary Professionals page. Do not write on the veterinary forms.

Veterinary Packet.pdf
Size : 356.896 Kb
Type : pdf

Applicant Packet.pdf
Size : 1524.685 Kb
Type : pdf