I declare that I have exhausted all alternative options available to me for financial assistance, however, I agree to reimburse the Paw Philanthropy for any funds received upon a change in my financial circumstances. In addition, I hereby assign to the Paw Philanthropy all rights to any amounts received from insurance or other source of recovery related to this matter. I do not operate any form of breeding facility for profit and agree to provide any documents needed in support of this request. I understand that the Paw Philanthropy is not responsible for the treatment and/or result of any veterinary services provided and hereby waive any and all claims for liability against the Paw Philanthropy, and that the Paw Philanthropy hereby reserves the right to deny a Request for Financial Assistance to anyone for any reason. I understand that Paw Philanthropy is not financially responsible for charges incurred at the treating veterinary hospital prior to the submission of this application. I understand that if I am approved for funding, I am not automatically approved for any further assistance. I authorize the Paw Philanthropy to use my and/or my pet’s photograph and any information relating to the payment of funds pursuant to this application for any purpose. I understand and agree for Paw Philanthropy to contact and validate the information provided. I acknowledge that approved funds will be paid DIRECTLY to my veterinarian/veterinary hospital. I declare, under penalty of perjury, that the foregoing is true and correct to the best of my knowledge. I also agree that any funds provided and not used will be transferred back to Paw Philanthropy from the Veterinary Hospital or Vet.