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Medical eligibility

Welcome to the Medical Eligibility page of the Zeus & PJ Charitable Foundation. This page is dedicated to providing the necessary medical forms required to assess eligibility for funding assistance for dogs diagnosed with cancer.

Important information for veterinary surgeons

You have been asked to complete this form because the owner of a dog in your care has applied for grant assistance from the Zeus & PJ Charitable Foundation to help cover the costs of their dog’s cancer treatment.

 

Please select and complete the appropriate Medical Eligibility Form from the two options below:

  • First Consultation – for dogs being referred for an initial consultation at a specialist cancer treatment centre.
  • Cancer Treatment – for dogs whose cancer diagnosis has been established and who are being considered for cancer treatment at a specialist cancer treatment centre.

 

Simply click “The Medical Eligibility Application Online Form” below. You will be asked to select either “First Consultation” or “Cancer Treatment” on the next screen.

 

The Medical Eligibility Application Online Form

 

Downloadable forms

If you prefer to submit a physical form or need a copy for your records, please download the appropriate form below.

 

Once completed, send them to admin@zeusandpj.org

Medical eligibility form for dog’s First Consultation Application

This form should be completed by the veterinary surgeon at the primary care practice for funding assistance related to the dog’s initial consultation at a specialist cancer centre.
Medical Eligibility Application Form (First Consultation) (217.48 KB)

Medical eligibility form for dog's Cancer Treatment Application

This form should be completed by the specialist veterinary surgeon at the referral treatment centre for funding assistance related to the dog’s ongoing cancer treatment.
Medical Eligibility Application Form (Cancer Treatment) (228.00 KB)

Explanation for the dog owner:

 

The Medical Eligibility Form must be completed by the veterinary surgeon responsible for the dog’s care.

 

  • If you are applying for an initial consultation at a Cancer Treatment Centre, the form should be filled out by your regular veterinarian who is recommending the consultation at the Specialist Cancer Treatment Centre.

 

  • If you are applying for funding assistance for your dog’s cancer treatment, the form should be completed by the oncologist who last examined your dog and recommended the proposed treatment at the Specialist Cancer Treatment Centre.