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Pet Assistance, Inc..........helping people and their pets since 1973

Emergency Aid Application Questionnaire

Date submited

Thu Jul 22 2021 18:54:51 GMT+0000 (Coordinated Universal Time)

First Name

Natividad

Last Name

Kehr

Phone numbers (home and cell)

773-899-1309

Address

7927 West Elmgrove Drive

City

Elmwood Park

State

IL

Zip Code

60707

Pet's Name

Smokey

Age

6

Gender

Male

Neutered

Yes

Problem description

Smokey has glaucoma and is in need of surgical eye removal.

Symptoms

Foggy, blue, and swollen eyes along with headaches.

Veterinarian's diagnosis

Posterior Lens Luxation right eye, Glaucoma right eye, Lens instability left eye

Prognosis

Glaucoma with eventual blindness

Proposed course of treatment

Eyedrops every 6 hours

Cost estimate

700

Amount already spent

12,000

How much more can you spend

700

Name of hospital

3305 N. California Ave

City located in

Chicago

State

IL

Hospital Number

773-899-1309

Pet Assistance, Inc. cannot financially help with a pet's care unless the owner an contribute.