Compassionate Assistance Program
Cat's Name
Your answer
Cat's Age
Your answer
Date of Diabetes Diagnosis
MM
/
DD
/
YYYY
Owner's Name
Your answer
Owner's Address
Complete mailing address including any apartment/unit numbers and zip code
Your answer
Owner's Phone Number
Your answer
Owner's Email Address
Your answer
Veterinarian's Information
Include name of vet, name of clinic/hospital, address, phone and fax numbers, and a website (if applicable)
Your answer
Prescribed Insulin
Do you test your cat's blood sugar at home?
What are you feeding your diabetic cat?
Please include anything your cat has access to such as food for dogs, food for other cats, table scraps/people food and if the cat goes outdoors or not
Your answer
Have you joined an internet forum for diabetic cats?
If you have already joined a forum, please tell us your username
Your answer
What makes you a low-income caregiver?
The Compassionate Assistance Program is a need-based program not a "want" program. We understand that insulin prices, especially for Lantus have risen dramatically in recent years. If you just need guidance on how to find insulin and test strips more cheaply, please contact us at jenna@dcin.info
Your answer
Information about our program
By placing your name in the box below, you understand that the Compassionate Assistance Program is a one-time program to provide insulin (and testing supplies if hometesting) to a low-income caregiver. Any further requests for assistance will be on a case-by-case basis and at this time there is no guarantee for on-going assistance. DCIN does frequently have people offer insulin for free or low-cost and you would, of course, be eligible to work with the person making the offer to obtain this insulin. DCIN also has information about obtaining Lantus/Levemir less expensively and recommend an online pharmacy over a vet's office to obtain ProZinc. We will do our best to assist clients in sourcing affordable income before their insulin runs out.
Your answer
Picture/Prescription - Please email a picture of your kitty and a copy of the prescription to intake@dcin.info. If you need to text them, please text it to 410-499-3390.
Your answer
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