Medical Fund Application

Bandit’s Medical Fund Application Process & Guidelines

Please fill out the medical fund application completely and with as much detail as possible. This is your opportunity to make the case for why our organization should provide assistance to your dog. We generally respond via email within a few days of receiving completed applications.  

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Name of Applicant
Applicant's Address
(Copy and paste link from top of your Facebook profile - put N/A if not on Facebook)
( May be different from your primary veterinarian)
Veterinarian's Address
Do you agree to provide bank statements, SSI award letters, tax returns, and other financial documentation to support your application plus photos of your dog?