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HOPE BEFORE HEAVEN INC.
P.O. BOX 2002
NEW MARKET STATION
NIAGARA FALLS. NY 14301
PHONE: 716-236-7346 FAX: 716-236-7137
EMAIL: email@example.com WEB:hopebeforeheaven.com
REQUEST FOR HELP
To receive help from HOPE BEFORE HEAVEN INC. you will have to exhaust all
Apply for credit from Care Credit for Pets (1-800-677-0718)
A. If accepted amount $________________
B. If denied we need the denial code__________________
Ask family or friends.
Use your credit cards.
Does clinic belong to Pet Emergency Fund of WNY?
A. If yes will they help and what amount? $_____________
B. If no why? ____________________________________
Do you have pet insurance? A. Yes_____ If yes you will have to fill out the
Release and Authorization of Payment form.
B. No _____
6. Have you asked clinic if they will take payments?
A. Yes _____ If yes how much down payment is needed ? $______
B. No ______ If no Please ask.
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