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Cremation Assistance Application
This form should be used if your pet has passed away and you are in need of cremation assistance. If you are in need of emergency veterinary care or diagnostic testing assistance, please fill out the Application for Emergency Veterinary Care and/or Diagnostic Testing Assistance form.
***Please be sure to check your email to make sure you received a copy AND watch for an email from a volunteer after we have received your application.
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Email
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Your email
Rainbow Bridge Photo Credit: Caitlin-Marie Miner Ong
Are you requesting Cremation Services for a deceased pet?
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Yes
No
Do you understand IF approved, Hobo's Healing Heart pays grant money directly to the veterinary clinic and NOT the pet owner?
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I understand and agree
I do not agree
Which county to you reside in?
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Butte County, South Dakota
Custer County, South Dakota
Lawrence County, South Dakota
Meade County, South Dakota
Pennington County, South Dakota
Crook County, Wyoming
Pet Name
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Your answer
What species is your pet?
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Dog
Cat
Other:
Required
Approximately, what is your pet's weight?
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Your answer
Owner's First Name
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Your answer
Owner's Last Name
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Your answer
Physical Address
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Your answer
City
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Your answer
State
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Your answer
Zip Code
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Your answer
Is your mailing address the same as your physical address? If yes, enter "N/A". If no, please provide your PO Box, City, State, and Zip
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Your answer
Phone Number (with area code)
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Your answer
Name of preferred Veterinary Clinic or Crematory
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Your answer
Phone Number of Veterinary Clinic or Crematory (with area code)
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Your answer
What is the estimated cost your vet provided you for cremation services?
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Your answer
Have you applied with Hobo's Healing Heart in the past?
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Yes
No
How did you hear about Hobo's Healing Heart?
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Your answer
If approved, I would like you to share a memorial for my pet and a testimony about what it means to receive this assistance?
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Yes
No
I will submit photos, a memorial, and testimony about what receiving assistance will mean to my family using the following method:
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Text message to 605-569-6919
Email to
hoboshealingheart@gmail.com
- Subject Line: (Pet and Owner Name)
Facebook Messenger to Hobo's Healing Heart
Not Applicable
A copy of your responses will be emailed to the address you provided.
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