Rescue Dog Financial Assistance Application

Australian Cattle Dog Rescue, Inc. ® (ACDRI) has implemented a financial assistance program for persons or groups rescuing purebred Australian Cattle Dogs. This major medical assistance is available for expenses which are above and beyond the routine examination, vaccination, spay/neuter, heartworm test and intestinal parasite test expenses. Our goal is to make it possible for these rescue dogs to regain the physical health necessary to be placed in loving, forever homes.

No Guarantee

Please be aware that we have a yearly budget for financial assistance, and a request does not guarantee assistance will be granted. All approved financial assistance checks will be sent directly to the veterinary clinic providing the medical care for this dog.

Guidelines

See our Financial Assistance Guidelines.

Name of rescue group/person *

Address: *

Phone Number *

Email Address: *

Name of any ACDRI board members to whom you are known: *

Names and contact information for two other rescue people/groups from whom we can attain references: *

Name of dog requiring this medical care: (pictures must be submitted with application) *

What sex is the dog? *

Male

Female

How did this dog become available for rescue? *

Nature of medical care needed: (written statement from attending veterinarian containing diagnosis, treatment options, prognosis and cost estimate, or actual cost of treatment administered, must be sent with application) *

Name, address and phone number of the veterinarian/clinic providing this care: *

Date which medical treatment was or will be performed: *

Amount of assistance requested: (We may not be able to meet your total request but will do our best to assist) *

Any additional information you feel we should consider for your request: *

By signing below you are stating that all information provided is true to the very best of your knowledge and that the funds provided are for the exact purpose and dog as stated above.

Signature of applicant: *

Today's Date: *

Upload dog's pictures, Veterinarian diagnosis, treatment and cost estimates

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