WestieMed's desire is to
help a greater number of Westies in need during these difficult economic
times, therefore, we find it necessary to limit funding for any one
individual applicant or rescue group to a maximum of $2,000 and restrict funding for the same person or group to no more than once every three
(3) months. Per our Funding Guidelines, each case will be assessed on an
WestieMed Application Form:
Applying for financial assistance from WESTIEMED is a simple process, but we regret that not all applicants, dogs, or medical conditions will meet our funding criteria. To determine whether your Westie is eligible for financial assistance through WESTIEMED, please read our
Once you've confirmed that your Westie meets all of our requirements, the next step is to fill out this application. At the end of this application, you will be asked to confirm that you have read all of the above and understand that if funding is approved, you agree to abide by all rules and contingencies set forth by the organization. Please ensure that you have read those items prior to filling out this application.
Please fill out the Application Form below completely.
Incomplete applications will not be considered. Failure to supply the requested information
(i.e., Westie's photo, veterinary receipts or invoices, etc.) will result in a delay and could result in a denial of your request.
After submitting your application form, you will receive a response within 48 hours.
If you have any questions or problems submitting this form, please contact
email@example.com or call the toll-free WestieMed Message Center at 1-877-853-9469.
If this is a life or death emergency and you need a response from us within 24 hours, then YOU need to make sure we are provided with the following:
- The vet must be available to speak with a WESTIEMED representative.
- You must get a picture of the dog to us within 24 hours. You can
e-mail a picture to
firstname.lastname@example.org. If you are not able to e-mail one, but choose instead to send one by overnight mail, the address is:
342 Black Gold Dr.
Harrison, OH 45030
If you do not have a camera, you may want to purchase an inexpensive disposable camera, take photos of the dog requiring assistance, have the film developed at a one-hour or overnight photo shop, and forward the photos to WestieMed. Some photo shops offer services where they will put the photos on a disk for you.
- In the medical section of the application, please give us as much detail as you can on the nature of the treatment needed and information on what treatment has already been given.