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Medical Care Funding Request Application

What is your pet?
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How will you be paying? (select all that apply)

I hereby certify that the above statements are true and correct to the best of my knowledge. I understand that a false statement may disqualify me from receiving Vet Partners Cares funding. Furthermore, I release the State of Minnesota, the Board of Directors, officers, employees and agents for any loss, personal injury, accident, misfortune or damage to myself or my property. With the understanding that reasonable precautions shall be taken to ensure the health and safety of myself and my property.

I grant to Vet Partners Care, its representatives and employees the right to take photographs of my pet. I authorize Vet Partners Cares, its assignees and transferees to copyright, use and publish the same in print and/or electronically. By entering your signature below, you agree to the terms listed above.

Thanks for submitting! Please remember to email with your proof of financial need within 24 hours.
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