MyPetChild Grant Pre-Screening Form
This form is where you will start the pre-screening process for the financial grant offered by MyPetChild.com. Visit the following link for full guidelines:

https://www.mypetchild.com/financial-aid-program/
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Full Name *
Home Address *
Phone Number *
Pet *
Pet Breed *
Pet Age *
Diagnosis & Estimate Cost *
Please provide some details on your pet's medical needs, the treatment your pet requires, and the estimate cost for the treatment.
Veterinary Practice Details *
Please include the name and address of the veterinary practice where the diagnosis was received.
Will you be able to provide proof of financial hardship? *
Can you confirm the treatment your pet requires is non-routine and non-emergency? *
Other supporting details
Any other details that may help us better understand your situation and your pet's medical need. Please don't include any sensitive details.
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