Better Together Request - Humane Society of Southern Wisconsin

Better Together Program Request Form

With the help of Petco Love and community donations, we are able to support both the pets in our community and the people that love them to remain together through our Better Together Program. Specifically, this program can help with expenses that help keep pets and their families together up to $200. If $200 would help you to be able to stay united with your pet and avoid surrendering/rehoming them or making the very difficult decision to euthanize them, please fill out the request form below.

There is no answer to the questions below that would immediately disqualify someone, but preferences will be given to those living in Rock County and are facing financial hardship. There are also a few items that this program will not cover at community vet clinics, but can help with if you receive those services at HSSW. These items are things such as wellness/annual visits, vaccines, and spay/neuter services.

If you are looking to schedule a low-cost wellness/annual visit, please visit us HERE. If the low-cost wellness/vaccine services are still outside your budget, please contact our Clinic Assistant, Hailey, at hbartlett@petsgohome.org. If you are looking to schedule a low-cost spay/neuter appointment, visit us HERE. If the low-cost spay/neuter services are still outside your budget, please contact our Surgery Team at surgery@petsgohome.org.

Better Together Program Request Form

Please enable JavaScript in your browser to complete this form.

Your Information

Name

First

Last

Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Pet's Information

Name

Species

Dog
Cat
Other

Vet Clinic Information

If you are filling out this form for help with something non-vet care related, please enter N/A for the questions in this section.

What is the name of the vet clinic where your pet will receive treatment?

Phone Number of the Vet Clinic

Describe the injury or illness that your pet needs vet care for.

If you are reaching out to us for non-vet care related help, please explain what you are looking for help with.

If you are reaching out for vet care related help, please enter N/A here.

Program Related Questions

Have you ever received help from our Better Together (formerly the Happy Home, Safe Home Program) or our Sophie's Gift Program before?

If you have received program help before, please explain how we helped and when.

How many adults are in your household?

How many kids (under 18) are in your household?

What is your annual household income?

Do you receive any state or federal assistance? If so, please list them here.

If this does not apply to you, please enter N/A in this section.

so, total for

We understand that the cost of many things has grown to be very expensive. Please share information about your specific circumstances and why you are reaching out to us for help.

If you are unable to receive help from this program, what will you do?

For Example: Surrender your pet, Apply for Care Credit, etc.

What is the estimated total cost of what you are looking for help with?

How much are you able to contribute to this total cost?

Have you applied and been approved for Care Credit or Scratch Pay?

If you are looking for non-veterinary care help, please enter N/A here.

If so, for what amount?

What is the current available credit?

By submitting this application, I agree that it has been completed in good faith. I understand that the submission of false information may result in my request being denied.

I Agree