Application for Veterinary Care Assistance

We do not provide Preventative Care.
(e.g. Heartworm pills, flea treatments, regular veterinary care, etc.)
This Application should only be used in cases where Emergency Assistance is being Requested.

Request for Assistance

Basic Household Information
Are you an enrolled member of the Eastern Band of Cherokee Indians? NOTE: this question is ONLY for statistical information *
Please tell us about the pet that needs our help. If there is more than one pet, please note that in the comments section and choose one to describe below.
For example: Siamese, domestic short hair, mixed, german shepherd, schauzer, cockatoo, etc.
We ask where the pet is housed because if surgery is necessary, and for spay/neuter, there is usually a requirement for animals to be kept quiet and contained. We must know that you are prepared for this possibility, or that you will work with us for arrangements to be made for this to be accomplished.
NOTE: This does not include an emergency vet clinic you are utilizing currently. This would be a veterinary clinic you take your pet(s) to for routine preventative care such as rabies shots, check-ups, etc.
Do you receive government assistance?  (ex: food stamps, Medicaid, low income housing) *
Has your household income been impacted by the COVID-19 pandemic? *
Advocates for Animals in Jackson County, Inc. requires all funding recipients to:

  1. Consider a future monetary donation when your financial situation improves.
  2. Consent to follow-up phone calls/emails from an AAJC representative within 2 weeks, 6-months, and 1-year post-assistance. If AAJC does not hear back after two attempts to contact you, you will not be eligible for any future assistance from AAJC.
  3. Inform AAJC if your address and/or phone number changes during the 12-month post-assistance period.
By entering my name below and submitting this form, I certify that I am agreeing to these requirements and that the answers on this application form are true and correct to the best of my knowledge. I agree to release Advocates for Animals in Jackson County, Inc. and its service providers (veterinarians, trainers, and fosters) from liability should the veterinary care, foster care, or behavioral training rendered prove unsuccessful or the animal becomes ill or injured while in our care.