Financial Assistance Request, Tuna's Guinea Pig Rescue

Date / Time

Name

First

Last

Email Address

Address

Name of Guinea Pig(s)

Guinea Pig(s) Gender

Briefly explain why you need asssitance:

What supplies do you require?

Hay Pellets Vitamin C Supplements Veggies Cage Supplies (Hides, water bottles, etc) Medications Vet Care/Medical Procedure Other

Would you like assistance with parasite/flea/tick treatments, baths, nail clips or boar cleaning?

Yes No

Will you agree to a home visit or digital video meeting to do a wellness check?

Yes No

Vet Care and Medical Requests

Only complete this section if the request is for medications or medical care.

Veterinary Hospital/Vet Name

If your pig(s) have not yet been seen by a vet for this issue, enter "NONE YET" in the above box. Leave the contact info and box blank.

Vet Contact Information

Date Last Seen by a Vet

Current Diagnosis or Medical Need

Approximate Cost of Medications and/or Procedures