Delta Dogs Program Application
Delta Dogs is a non-profit, community supported organization that believes that a person’s ability to provide love and compassion to their pets is not based on their net worth. Our mission is to provide routine, basic veterinary services to pets (annual vaccines, flea/heartworm meds, spay/neuter) owned by people who live below the federal poverty guidelines (2019 HHS Poverty Guidelines:
). We DO NOT provide emergency services for pets at this time.
Please review our program rules before you fill out an application:
1. You must live within the limits of Mobile County. We currently don’t have funding to support other counties.
2. You must agree to spay or neuter all of your pets. This is not negotiable, but we provide this as a free service.
3. You must agree not to obtain (e.g. adopt, buy, take in, rescue, etc.) any more pets. All pets in your home must be part of the Delta Dogs Program.
4. We do not support any animal breeding. No exceptions.
5. You must be able to provide evidence of your financial status (from your application) at your first appointment. For more information, see
PERSONS IN FAMILY ---> HOUSEHOLD INCOME MAX
1 - $12,490
2 - $16,910
3 - $21,330
4 - $25,750
5 - $30,170
6 - $34,590
7 - $39,010
6. You are requesting "routine care" for your pet. Routine care is defined as annual wellness exam, vaccines, heartworm test, flea/heartworm prevention, fecal/intestinal parasite test, and spay/neuter surgery.
7. At this time, the following are examples of things NOT covered by our program: emergencies, dentals and tooth extraction, grooming care, other types of surgery, follow-up care for surgeries done by other clinics, and care of cat colonies or TNR. If you apply and request care for one of these things, you will not be contacted.
8. After you fill out an application, a Delta Dogs representative will contact when you are next on the waiting list for our program. We frequently have a waiting list due to high demand for care, so it could take several weeks to be contacted.
This section contains questions pertaining to the human owner. Please fill out each section and make sure your contact phone number is correct, and it is a number that you can answer. Please make sure your voicemail is accessible and not FULL. If we call and can't reach a new applicant after two tries, we move onto the next application.
Applicant Name (First Name and Last Name)
Street Address (if you are currently homeless, please state that)
City, State, Zip Code
Phone Number (please include area code)
Please make sure this is a working number that you have access to. Interviews and appointments are made by phone.
Date of Birth (mm/dd/yr)
Last Four Digits of Applicant's Social Security Number
Do you have transportation or can your secure transportation to veterinary appointment within the city of Mobile? Please explain.
Page 1 of 4
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service