CDHS is an organization that relies exclusively on private donations to help pets like yours. Due to limited funding, not all qualifying applicants will be awarded assistance. Funding decisions are made at the discretion of CDHS and based on: fund availability, financial need of owner, the
opinion of the treating veterinarian as to the medical necessity, urgency and prognosis for the treatment needed. For those granted financial aid, CDHS will determine the amount and conditions to be funded.

If CDHS approves an application, we will contact the individual requesting assistance as well as the treating veterinarian to identify what procedures will be covered. Treatment can be scheduled only after notification of both parties by an authorized CDHS representative. The balance of any additional treatment/service costs elected by the applicant that were not pre-approved by CDHS will be the financial responsibility of the applicant. Once provided with an invoice for services rendered, CDHS will disburse the approved funds directly to the veterinarian or service provider.

I have read and understand the above application and attest that the information I have provided to CDHS is accurate and complete.

I acknowledge that CDHS reserves the right to demand repayment if I have provided any false information regarding my income qualification or eligibility for consideration, and may opt to pursue such a claim in a court of law.

I further certify that I am the legal owner of the pet(s) named above and give my consent for the above-mentioned medical care and/or services. I release this organization, its officers, employees and volunteers from any and all liability and I understand CDHS makes no assurances as to the appropriateness, quality or outcome of any medical diagnoses, treatments, products or services.