How to apply for help

Please complete the following information regarding you and your pet:

Tell Us About Yourself

* Indicates required field

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Primary Phone *

Cell Phone *

Email *

Active Duty or Veteran *

Military Branch *

Rank (Please note if retired) *

Base *

How did you hear about the HP Program? *

Please provide a detailed description of what's wrong with your pet and what your concerns are *

Explain why you are unable to cover the costs for your pet at this time *

Tell us about your military service (i.e. years served, any deployments or achievements): *

Tell Us About Your Pet

Pet's Name *

Age *

Breed *

Color *

Pet's Sex *

Male Female

Weight *

Are you able to pledge a recurring donation each month to Helping Paws? If so, how much? *

Click here to make your pledge

I declare that I have exhausted all alternative options to me for financial assistance and I agree to (initial next to agreed upon term):

I agree to reimburse Helping Paws for any funds received upon a change in my financial circumstances. *

I agree to volunteer for Helping Paws’ special events and fundraisers *

I authorize Helping Paws to use my and/or my pet’s photograph, video and any information relating to his or her procedure and outcome. This is required for fundraising purposes. Please notify us if you are unable to agree to this. *

Which hospital location do you prefer to visit: Carlsbad, Escondido or Vista? *

I hereby contest that:
- I do not own or operate any form of for-profit breeding or pet shop.
- I understand that these funds are to be used at a participating Helping Paws veterinary hospital.
- I understand that Helping Paws is not responsible for the treatment and/or outcome of any veterinary services provided and hereby waive all claims of liability against the Helping Paws charitable fund.
- I understand that Helping Paws reserves the right to deny a request for financial assistance to anyone for any reason.
- I declare, under perjury, that the foregoing is true and correct to the best of my knowledge.

Full Name as Signature *

Date *

*To expedite your need, we encourage you to apply for Care Credit and forward their response to us at info@helpingpawssandiego.org. Once you hit submit, read the confirmation page for instructions and check your spam file if you don't receive a confirmation email.

Submit

Helping Paws Help Request

​Tell Us About Yourself

​Tell Us About Your Pet

Tell Us About Yourself

Tell Us About Your Pet