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PLEASE READ THE FOLLOWING NOTIFICATION PRIOR TO COMPLETING AN APPLICATION: We simply DO NOT have the funds for the following:

Diagnostics, testing , CT scans or x-rays.
General and/or routine veterinary care (examples: vaccinations, office visits, blood work, testing, dental cleanings)
Treatment that has already been performed. If your dog has already had surgery, been treated, etc., we do not help with those incurred vet bills.

We are not equipped to respond to emergency situations and urge you to search elsewhere if you find your pup is in a life/death situation requiring immediate medical attention.

It is our requirement that all dogs we help be spayed/neutered prior to our providing financial assistance. In rare cases when physically possible, this can be done at the same time as the needed medical treatment IF the treating veterinarian will perform the sterilization at the same price as a low cost spay/neuter clinic. Additionally, it is our requirement that all dogs in the family must have been sterilized or are scheduled to be spayed or neutered in the near future. We understand that due to medical concerns not all dogs can be sterilized. In those cases we require confirmation directly from the attending veterinarian.

the application MUST be filled out entirely before we can consider you for any financial aid assistance.

WE ARE CURRENTLY ONLY ACCEPTING CANCER RELATED APPLICATIONS

- Step 1 of 6

How Did You Hear About Us? *

Referral Name

Have We Ever Helped You Before? *

Yes
No

Due to our limited funds, The Mosby Foundation is only able to assist dog owners on a one-time basis. If you have only received help through our spay/neuter program, please go back and answer ‘no’ to the question. If you have received other forms of assistance please don't go any further.)

Dog Guardian Information

Name *

First

Last

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Phone (Primary) *

Dog Information

Name of Dog *

Breed *

Sex of Dog *

Male
Female

Approximate Age *

Months
Weeks
Years

Spayed or Neutered *

Yes
No

Our guidelines state that the dog must be spayed/neutered or will be at the time of surgery.

If No, Please Explain

Up to Date on Rabies & Distemper Vaccines? *

Yes
No

If No, Please Explain

Are You Affiliated With A Rescue Group? *

Yes
No

If So, Name of Group

How Did You Acquire Your Dog? *

How Long Have You Had The Dog? *

Diagnosis & Costs

Veterinarians Diagnosis *

Recommended Course of Treatment *

Estimate From Veterinarian For Treatment *

Is Surgery Already Scheduled? *

Yes
No

What is the Date?

Veterinary Hospital Phone

Veterinary Hospital Email Address

Do you have pet insurance? *

Yes
No

Upload the Vet Estimate

Click or drag files to this area to upload. You can upload up to 3 files.

How Much Can You Contribute? *

Other Funding Sources

The Mosby Foundation encourages applicants to seek financial assistance from many sources as we are never able to cover all of the cost of treating your dog.

Have you applied to other groups or launched a fund raiser? *

Yes
No

Please List Name of Group *

Have They Offered Assistance? *

Yes
No

If So, How Much? *

Have You Applied For Care Credit? *

Yes
No
My Vet Doesn't Accept Care Credit

Care Credit Status?

Approved
Denied

If So, How Much?

Uploads

Upload a Photo of Your Dog Here

Click or drag files to this area to upload. You can upload up to 3 files.

JOIN OUR MAILING LIST

Email *

First Name *

Last Name *

QUICK LINKS

Application
Financial Aid

MAILING ADDRESS

PO Box 1978
Staunton, VA 24402

LOCATION

11 N Central
Staunton, VA 24401

Mosby – 1997-2003

© 2024 The Mosby Foundation
Nationally Recognized for Caring for Dogs in Need.
The Mosby Foundation is a 501(c)(3) non-for-profit organization.
A copy of our 990 available upon request.

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