PBRC Spay Neuter Request - Kelly Lewis georgia

[kellyd...@yahoo.com]

PBRC SPAY/NEUTER FUND APPLICATION

Date: Sat Apr 16 9:00:29 2011

OWNER OR CARETAKER INFORMATION:

Name: Kelly Lewis

Address: 5307 Weslock Court

City: Norcross

County of residence: Gwinnett

State : georgia

Zipcode: 30093

Phone: 7708990751

E-Mail Address: kellyd...@yahoo.com

What is your dog's name?
kane

What is your dog's age?
0 to 6 months

What is your dog's weight?
20

What is your dog's gender?
male_neuter

What is your dog's breed?
APBT

Do you own the dog?
i am fostering/rehoming the dog

How long have you had the dog?
2 weeks

Is this dog up for adoption?
avail_yes

If so what is the rescue name?
me

Veterinarian's name:
not sure

Veterinary hospital or clinic name:
lifeline animal project

Veterinary hospital or clinic address:
2533 sullivan rd

Veterinary hospital or clinic city:
college park

Veterinary hospital or clinic state:
georgia

Veterinary hospital or clinic zipcode:
30337

Veterinary hospital or clinic phone number:
6789732881

Veterinary hospital or clinic fax number:
6789732843

Veterinary hospital or clinic contact name:
whitney

Cost of surgery:
65

Amount willing to contribute:
16

Amount requested:
49

Does your household receive public assistance?
yes

If so what type of assistance?
ssi

Are there circumstances that we need to be aware of
that would make the procedure more costly?
is procedure considered pediatric if testicals have descended?

Have you contacted low cost spay/neuter resources for your area?
yes. georgia humane society. cash flow issue prevents neuter funding at current time.

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

Have you applied previously with PBRC for assistance?
No

How did you hear about the PBRC spayneuter assistance program?
whitney @ lifeline

[sanya]

Hello

We have received your request for spay/neuter assistance. Thank you for making the choice to alter this dog.  

Are you working with any rescue or shelter organizations to rehome the dog? 

Please e-mail a photo of Kane to speut...@gmail.com for our records.

Once we have this information you should hear back from us within 3 business days advising you if your request has been approved. If your request is approved we will make payment directly to your Veterinarian's office.

If you have any questions please contact us.

Sincerely,

Sanya
PBRC Spay/Neuter Committee
pbrc-sp...@googlegroups.com

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