Veterinarian’s Pet Information Form (VPIF)

Broken Tails cannot assist with charges incurred prior to approval of application. If your client is approved for a grant, Broken Tails will remit payment by check via USPS following completion of treatment and receipt of your invoice. By selecting ‘I Agree' below, I affirm that I understand and accept Broken Tails requirements, payment policies, as outlined above and detailed on the Grants page.

It also certifies that the information I have supplied above is true and that any false statements may result in nullifying this application. I further understand that this application is the property of Broken Tails and will be retained by them. By selecting ‘I Agree’ below, it constitutes an electronic signature that is valid and a legal substitution for my written signature.