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Need help for your pet?

Form

Request financial support

1. Owner Information

Contact details

Proof of residence

Provide an invoice or document in your name which contains your postal address (telephone, internet, Hydro-Québec, insurance, or other) that you received in the last 60 days OR a piece of identity with your up-to-date address.

Import file
Import file

Income Details

Tell us about your household's financial situation so that we can quickly assess your request for assistance.

You are a recipient of:
How many members make up your household?
How many animals do you have in total?
Total annual household income before taxes

Proof of income

Documents accepted:

- Income tax assessment notice

- Tax return

- Payslips

- Letter from employer

- Certificate of social benefits

- RSA (Revenu de solidarité active aka ‘social welfare benefits’) certificate

- Any other official document

Import file
Import file

2. Pet Information

If your animal was evaluated elsewhere than at Clinique vétérinaire HoMa, please ask your veterinarian to transfer the medical file and test results (if applicable) to soutien.upcdp@cvhoma.com

3. Details related to the request for financial support

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