Pet Medical Assistance | Circle of Friends Humane Society

We are partnered with MYRA Foundation to help offer some assistance with Veterinarian costs when an unexpected cost arises and an owner is struggling to afford to pay for Veterinarian expenses.

Exam/treatment assistance

Our Companion Animal Program is available to pet owners in financial need experiencing medical expenses with their pets.

Spay/neuter assistance

Spay/neuter certificates are available to members of the general public experiencing financial need.

The MYRA foundation and private investors believe in and are committed to keeping companions together. We know unexpected situations can arise creating circumstances of financial need for companion care.

Steps to the Application Process

The applicant must read the voucher agreement thoroughly, then fully complete the application.
On the first and third Tuesday of each month, the applications will be reviewed.

*If the application for assistance is approved:

The applicant will receive an approval email stating the cost that the voucher has been approved for, along with verifying the pet’s name and veterinary clinic being used.
The applicant can then pick up the approved voucher from Circle of Friends, or can choose to have it emailed to themselves.
The voucher must be used within 30 days of the approval date.
At the time of payment for the veterinary appointment, present the voucher to the clinic. The clinic will then deduct the amount approved on the voucher from the total cost.
The veterinary clinic will email or mail the detailed invoice to the Circle of Friends Humane Society.
After reviewing the invoice, Circle of Friends will pay the veterinary clinic directly for the approved voucher amount.
In order to continue receiving funding for the voucher program, applicants are encouraged to send Circle of Friends before/after pictures and/or stories or how the voucher program has helped their pet.

*If the application for assistance is denied:

The applicant will receive an email from Circle of Friends stating the reason for denial. The applicant may reapply once circumstances causing the denial have changed.

Veterinary Assistance

Step 1 of 2

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Connecting Companions Veterinary Assistance Agreement*
**If you are seeking voucher assistance, please carefully read the entire contents of this page.
It is imperative that you read each section before completing the application.

Due to the high demand for voucher assistance and our limited funds, vouchers are limited to one per animal per year. Also, if your application for voucher assistance is approved, you may not receive all of the funds for which you apply.

Vouchers can only be used towards spay/neuter costs, exam fees, or life-saving treatments ensuring that the pet stays with their owners. It is a one-time payment for emergent veterinary care, we cannot make continuous payments for ongoing services.

Vouchers will be reviewed the first and third Tuesday of each month. Once vouchers are approved, they expire after 30 days. If the voucher is not used, it cannot be reissued and the applicant will need to reapply.

Please be advised that the voucher program cannot assist with charges incurred prior to the approval of application and invoice by the veterinarian of the approved voucher form.

Voucher cannot be used as a reimbursement to the owner after veterinary bills have already been paid. They can only be used to pay the veterinary clinic directly. Funds are never disbursed to an applicant.

Circle of Friends will pay only up to the invoice balance due, even if the voucher was approved for a higher amount. The excess amount cannot roll over to another veterinary bill.

Decisions for approval are based upon several factors, including: medical urgency, financial need, available funding, and eligibility. Due to the overwhelming number of applications we receive, we cannot help everyone.

You do NOT qualify for voucher assistance if any of the following circumstances apply:
- -You do not plan to use one of the veterinary clinics listed on the application.
- -You are seeking reimbursement for a paid bill.
- -You are seeking payment for an outstanding bill.
By signing my name below, I confirm that I have read, understand, and agree with the above statements:

Type of Assistance Needed*
- Exam/Treatment Assistance
- Spay/Neuter Assistance
Name*

First

Last
Date*

Date Format: MM slash DD slash YYYY
Address*

Street Address

City

State / Province / Region

ZIP / Postal Code
Email*
Phone Number
Pet's Name*
Species*
Sex of the pet*
Age of the pet*
Breed of the pet*
How long have you had this pet?*
Where did you get this pet?*
Reason the pet needs to be seen by a Veterinarian*
Please select the approved veterinary clinic you will be using for the appointment:*
- All Pets Hospital
- Grand Valley Animal Hospital
- Kindness Animal Hospital
- Petcetera Animal Clinic
- Peterson Veterinary Clinic
What is an estimated total for this visit?*
How much assistance do you need towards the estimated cost?*
How many people live in your household?*
Do you qualify for:*
I am on unemployment and/or am the sole supporter for my family. There are no other working adults in my household.*
I am in a low income group:*
I am a full time active military:*
I am a full time student:*
I am on Social Security:*
If you are not part of any of the circumstances above, but have had personal circumstances please explain below:*
Please provide a brief description of what this voucher will mean to your pet. Your testimonial may be shared to aid in the continuation of receiving funds to assist with pets in need. Your name will remain anonymous.*
Can we use the photo of your animal for grant reporting?*
- Yes
- No
Please upload a photo of the animal you are requesting assistance for:
I release that Circle of Friends can share all the information above. Please print first and last name:*
Please sign releasing that Circle of Friends can use the above information. Thank you*
Phone

This field is for validation purposes and should be left unchanged.