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  • Request for Low-Income Medical Services at Angell at Essex

    Please provide the following information to be added to our waitlist for subsidized services; please be aware that these services are in extremely high demand, and we cannot guarantee an appointment for all who apply. If your pet is in need of emergent medical care, please do not wait for us to contact you; seek care at a regular veterinarian or emergency facility.

    1. About You

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    Name:

     

     

       

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    City/State/ZIP:

     

        

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    What's this?

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    *3.
    Question - Required - Please indicate how you qualify for Low-Income services (select all that apply). Note that income qualifying documents (SNAP/WIC card, housing letter, IRS 1040 form, etc.) as well as a matching photo ID will be required at all appointments in order for us to provide low cost care.
    Please make up to 7 selections from the choices below.

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    *5.
    Question - Required - Pet's Species (we only accept dogs and cats at this time)


    *6.
    Question - Required - Pet's Sex


    *7.
    Question - Required - Is your pet neutered/spayed or intact?


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    We will require documentation for public assistance programs and a rabies certificate if your pet already has a current rabies vaccine or has ever received a rabies vaccination.
     
    If you have further pets that require care, please fill out a separate application for each pet.
     
    We will call you to schedule as appointments become available. Please be aware that our low cost services are in very high demand, and there is currently a 4- to 8-week wait time for an appointment.
     
    Thank you for your interest and support of our programs!
       Please leave this field empty