New Client Application

I am applying to become a client and receive veterinary services for my pet(s) at the Atlantic County SPCA low-cost clinic. I understand that the Atlantic County SPCA's mission is to provide low-cost care to underprivileged pet owners, in an effort to reduce financial euthanasia and the surrendering of pets to animalshelters due to a lack of financial means.
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I certify that I am in need of this CHARITY CARE, and can present proof that I receive one or more of the following: Food Stamps, Medicaid (NJ Family Care), General Public Assistance, Rental Assistance, Aid to Families with Dependent Children, Lifeline Utility Credit, Tenants' Lifeline Assistance, Supplemental Security Income (SSI), Pharmaceutical Assistance to the Aged & Disabled).
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I received none of the above. However, I'd like to continue my application because:
I have been declined by 3rd party financing (ie. Care Credit) through my regular veterinarian. (I will provide documentation.)
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I have been affected negatively by the Covid-19 pandemic in the following way(s):

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Other:

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Atlantic County SPCA

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