HARBORS ASSOCATION OF VOLUNTEERS FOR ANIMALS (HAVA)
APPLICATION FOR VET ASSISTANCE

STEPS IN THIS PROCESS

  1. Review the qualifications below to make sure you qualify.
  2. Submit a copy of your "income proof"
    HAVA
    PO BOX 243
    Raymond, WA 98577
  3. You will be notified when you have been approved and what is covered.
  4. Contact one of our approved vets to schedule the appointment.
  5. The vet will bill HAVA only for what is covered. The remaining amount would be your responsibility.

QUALIFICATIONS

This program is limited to pet owners who are financially unable to pay the vet bill for their pet. You must meet the following household income qualifications in order to qualify. You will need to mail a copy of your “proof of income” to HAVA. Our mailing address is PO BOX 243, Raymond, WA 98577. If you are not sure if you qualify, please call us at (360) 942-4716 and we will let you know.

People in
household 
Max income to qualify
1 $33,250
2 $38,000
3 $42,750
4 $47,500
5 $51,300
6 $55,100
7 $58,900
8 $62,700

ACCEPTABLE LOW INCOME DOCUMENTATION:

  • Wage Statement/Paycheck Stub
  • SSI/SSDI Statement
  • Approval Letter for Cash Aid
  • Approval Letter for DSHS Medical Coupons
  • Unemployment Statement
  • L & I Statement
  • Approval Letter for Food Stamps

PARTICIPATING VETERINARIANS:

Country Pet Vet: 300 Parpala Rd Naselle (360) 484-7228
Vetters Animal Hospital: 2400 Ocean Ave Raymond (360) 942-3440
Willapa Veterinary Services - Raymond: 230 Ocean Ave Raymond (360) 942-2321
Willapa Veterinary Services - Grayland: 2012 State Road 105 Grayland (360) 267-4444 


PLEASE COMPLETE ONE FORM PER PET.

 

About You
About your Pet
Income details
Acknowledgement

By submitting this application you certify all the information provided on this application is accurate.

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