COMMUNITY OUTREACH — For Pitties Sake Rescue

we can help.

For Pitties Sake is a registered 501(c) 3 charitable all-volunteer organization and we are able to provide financial assistance to qualified residents of our community. Please fill out the application below if you are in need of financial assistance for the veterinary care of your pet.

We understand that emergencies arise, life happens, and people need help sometimes. Our first experience with our vet, RIAC, was with one of our personal dogs. He had a foreign body and required hospitalization to stabilize him for surgery. It was a very tight time for us and we really didn’t know how we would pay. Thankfully, RIAC allowed us to make a down payment and set up a payment plan. They didn’t know us and didn’t know if we would ever be back to pay. In that moment, we knew how amazing they were.

We want to be able to help others who find themselves in situations like that or who are needing help with vaccines, preventatives, spay/neuter, medications, etc. Please know that us asking for an application to be filled out is to help us maximize the number of pets we are able to help and not to judge your situation or your family.

Owner name

Email address

Mailing address

Phone number

Total monthly household income

Type of pet being treated

Breed and age

Name of pet being treated

Do you have insurance for this pet? If so, through which company?

Please provide a brief explanation of your need for financial assistance

How much are you able to contribute to your bill?

Who else is able to contribute and what amount?

I am aware that For Pitties Sake requires the spaying or neutering of my pet in order to provide financial assistance for any veterinary care that my pet may need. I understand that For Pitties Sake will assist in the cost of my pet's spay or neuter if this procedure has not already been done.

I agree

I am aware that any veterinary services paid for by For Pitties Sake must take place at Roanoke Island Animal Clinic.

Some exceptions may apply, ask us about it if you've started care somewhere else.

I agree

I understand that For Pitties Sake has agreed to help me financially with the vet care discussed and kept on record by For Pitties Sake. Any unforeseen complications or additions to treatment not discussed and recorded will not be covered by For Pitties Sake and will be the responsibility of the pet owner.

I agree

Is there anything else you want us to know?

Electronic signature

Today's date

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