A yes answer to any of these questions, will require documentation!!
Request for Assistance Application
You must apply for Care Credit (www.carecredit.com) before requesting assistance. If approved, supply account # and amount. If disapproved, copy of transaction #. You need not accept it if approved.
Name
Address
Email Address
Phone number
Pet Name and age
Diagnosis
Treatment
Estimated Cost
Applicants will be asked if they are receiving any of the following:
* State or federally funded welfare program
* Food Stamps
* Medicaid
* Social Security
* SSI Disability
* Unemployment
* Non-commissioned active military
* Extreme medical expense, loss of home due to natural disaster, etc.
If approved for Care Credit, amount authorized:
If disapproved, transaction number:
Please print and fill out the below Application. Return to: friendsofanimalsinneed@gmail.com