|Charly & Moose Memorial EMGP
|Thank you for your interest in Piggie Poo Rescue's Charly and Moose Memorial Emergency Medical Grant Program. The EMG is available to low-income families who meet our eligibility requirements, AS LONG AS THE FUND IS SOLVENT. Funds are limited. Thank you and best wishes!
||Please indicate the documentation that substantiates your financial hardship *
||Phone (use only this format XXX-XXX-XXXX) *
||Street Address *
||City, ST and Zip *
||Name of Pet *
||Does your piggy have any of the following symptoms *
||Please describe the physical condition of your pet. *
||Please read and acknowledge our Emergency Medical Grant (EMG) Funding guidelines: *
- Funding requests can only be made for animals that are in your personal care and that you have been the legal owner of for at least 30 days.
- Amount granted will be up to 50% of the total charges, not to exceed $100.
- You are eligible to apply for EMG once per year.
- Recipient MUST use our Veterinarian of Record, Dove Valley Animal Hospital in Cave Creek.
- Funds are be used to treat life threatening aliments only, and are intended to offset costs of the Office Visit, Minor Diagnostics and Medications ONLY.
- Funds do not cover any surgical procedures, routine medical care, or cosmetic procedures.
- Pets must survive a minimum 14 days following office visit and recipient of funds must make every effort to complete prescribed care at home as per Vet’s instructions.
- Funds will be awarded a maximum of 50% of the total invoice of approved charges, in an amount not to exceed $100.
- Funds will be made directly to the Veterinarian Clinic, Dove Valley Animal Hospital
- Recipient must include Piggie Poo Rescue as an Authorized Party for Release of Medical Information from Dove Valley Animal Hospital.
- Piggie Poo Rescue will review all procedures, prognosis, and charges prior to release of funds.
- Grant funding is not guaranteed and is limited to funds available.
||Please share any relevant information that you'd like us to know. *
||I swear and affirm that the information provided in this grant application is true and complete. *