Apply for Support

This application is preliminary, additional information may be required to be approved.

First Name

Last Name

Phone Number

Email Address

Pets Name

Species / Breed

Photo of Pet

Upload File

Upload supported file (Max 15MB)

Have you applied for additional assitance? (Care Credit)

Current Reson for Request of Funds:

If you are requesting funds for medical care for your pet, has your pet been examined in the last thirty days and if so where?

Has an estimate been presented? If so what is the estimate range for treatment?

Tell us how you heard of us:

By typing "YES" I acknowledge that my answers are true and complete to the best of my knowledge. If this application leads to receiving funds I understand that false/misleading information on my application or interview may result in my funds being revoked. I also authorize that Prescotts Pet Project board may be contacting my veterinarian for my pets previous medical records related to request.

Apply for Support

This application is preliminary, additional information may be required to be approved.

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