Keeping Pet’s Home Application

Requirements: Person(s) applying must be 60+ years of age and have a senior dog or cat 7 years of age or older. Person(s) applying must be on a fixed/limited income. Proof may be requested at any time. All applications must be approved by Lionel’s Legacy before services are rendered. Financial assistance for medical care is granted directly to your pet’s veterinarian, we do not reimburse individuals directly. Support is provided solely based on available funding for services. We do not provide emergency funding, requests may take up to 2 weeks to process. Requests must be made annually and may not exceed $650 per family annually.

Name
Address
Emergency Contact Name
Reference Name

Dog Information

Please submit 3 high quality pictures of the pet(s) you are seeking financial assistance for.
Max. file size: 256 MB.
Sex
Altered?
MM slash DD slash YYYY
MM slash DD slash YYYY
Has a Dental ever been performed?
Vet's Address

Request Information

Briefly explain why you’re requesting financial support for medical assistance.
Type of Support Requesting