WHITNEY: PBRC Spay Neuter Request - K9 Kokua (medical caretakers-K9Kokua.org) hawaii

[sanya]

For you...this is the LCO. This in the database under Char Naone of K9Kokua.

On Tue, Feb 15, 2011 at 6:33 PM, <ch...@k9kokua.org> wrote:

PBRC SPAY/NEUTER FUND APPLICATION

Date: Tue Feb 15 20:33:49 2011




OWNER OR CARETAKER INFORMATION:

Name: K9 Kokua (medical caretakers-K9Kokua.org)

Address: P.O. Box 2471

City: Waianae

County of residence: Honolulu

State : hawaii

Zipcode: 96792

Phone: 8088537268

E-Mail Address: ch...@k9kokua.org

What is your dog's name?
niele

What is your dog's age?
1 to 3 years

What is your dog's weight?
55

What is your dog's gender?
female_spay

What is your dog's breed?
APBT

Do you own the dog?
i own the dog

How long have you had the dog?
2 weeks

Is this dog up for adoption?
avail_no

If so what is the rescue name?


Veterinarian's name:
ewa animal house vet

Veterinary hospital or clinic name:
ewa animal house vet

Veterinary hospital or clinic address:
91-919 ft. weaver rd

Veterinary hospital or clinic city:
ewa beach

Veterinary hospital or clinic state:
hawaii

Veterinary hospital or clinic zipcode:
96706

Veterinary hospital or clinic phone number:
8086891797

Veterinary hospital or clinic fax number:
8086894427

Veterinary hospital or clinic contact name:
chris a.

Cost of surgery:
400

Amount willing to contribute:
271.50

Amount requested:
128.50

Does your household receive public assistance?
no

If so what type of assistance?


Are there circumstances that we need to be aware of
that would make the procedure more costly?
this girl is in heat and there is a $75 charge

Have you contacted low cost spay/neuter resources for your area?
we have been lucky to find a vet clinic that is willing to provide us a discount.


Do you have another application currently pending with
us for additional medical assistance?
No

Have you applied previously with PBRC for assistance?
Yes

How did you hear about the PBRC spayneuter assistance program?
internet


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