2026 Velvet Assistance Fund Application

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Base
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Increment
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Exam Cost
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VAF Income Calculation
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Income CheckSum
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Financing Checksum
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Financing Calculation
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Amount For Treatment
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Unique ID
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Which Velvet Assistance Fund program are you applying for?* This field is required.
Appointment for a Doctor's Exam or Euthanasia
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Discounted Exams for Families in Need

DoveLewis offers discounted exams through a combination of third-party financing and the Velvet Assistance Fund (VAF) for families experiencing financial hardship.
How to Get a Discounted Exam

STEP 1
Apply for financing through Cherry or Scratchpay.

STEP 2
If you are denied or approved for less than the cost of an exam, take a screenshot or photo of the result message.

STEP 3
Complete the Velvet Assistance Fund application and upload:
• Household income information
• Proof of income (photo or screenshot)
• Your financing result screenshot

STEP 4
DoveLewis reviews your application.

STEP 5
If approved, schedule a Velvet Assistance Fund appointment.
A deposit equal to 50% of the appointment cost is required to secure your appointment time. If no appointments are available, please check back for newly released times.
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Appointment Cost Information

Approved for partial financing
Exam cost: $150
Deposit to book: $75

Approved for VAF after financing denial
Exam cost: $75
Deposit to book: $37.50

Important

The Velvet Assistance Fund may be used once per household, per year. The Velvet Assistance Fund covers the cost of a doctor’s exam only. It does not cover procedures, diagnostics, surgery, or other major services. Appointments are added regularly, if none are available please check back soon!
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Please select which application you completed today* This field is required.
Scratchpay
Cherry
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Were you approved for either of these funding options?
Yes
No
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Amount Approved For* This field is required.
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Please upload your Scratchpay/Cherry Approvals or Denials Here* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Tell us about your pet's condition and your reason for seeking an appointment* This field is required.
Huge
Large
Normal
Small
Ok
Ok
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How did you hear about this program?* This field is required.
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Your Name* This field is required.
First Name
Last Name
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Pet's Name* This field is required.
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Pet's Age* This field is required.
Number
Years
Please Select
Years
Months
Days
Unit of Time
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Pet's Sex* This field is required.
Male Intact
Male Neutered
Female Intact
Female Spayed
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Pet Breed* This field is required.
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Phone Number* This field is required.
Please enter a valid phone number.
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Email* This field is required.
example@example.com
Confirm Email
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Address* This field is required.
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Please Select
Please Select
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Anguilla
Antigua and Barbuda
Argentina
Armenia
Aruba
Australia
Austria
Azerbaijan
The Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Christmas Island
Cocos (Keeling) Islands
Colombia
Comoros
Congo
Cook Islands
Costa Rica
Cote d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Democratic Republic of the Congo
Denmark
Djibouti
Dominica
Dominican Republic
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Falkland Islands
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
The Gambia
Georgia
Germany
Ghana
Gibraltar
Greece
Greenland
Grenada
Guadeloupe
Guam
Guatemala
Guernsey
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jersey
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macau
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Martinique
Mauritania
Mauritius
Mayotte
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Montserrat
Morocco
Mozambique
Myanmar
Nagorno-Karabakh
Namibia
Nauru
Nepal
Netherlands
Netherlands Antilles
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
Turkish Republic of Northern Cyprus
Northern Mariana
Norway
Oman
Pakistan
Palau
Palestine
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Pitcairn Islands
Poland
Portugal
Puerto Rico
Qatar
Republic of the Congo
Romania
Russia
Rwanda
Saint Barthelemy
Saint Helena
Saint Kitts and Nevis
Saint Lucia
Saint Martin
Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Slovakia
Slovenia
Solomon Islands
Somalia
Somaliland
South Africa
South Ossetia
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard
eSwatini
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Transnistria Pridnestrovie
Trinidad and Tobago
Tristan da Cunha
Tunisia
Turkey
Turkmenistan
Turks and Caicos Islands
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
British Virgin Islands
Isle of Man
US Virgin Islands
Wallis and Futuna
Western Sahara
Yemen
Zambia
Zimbabwe
Other
Country
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Social Security Number* This field is required.
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Total Number of People In Household* This field is required.
1
2
3
4
5
6+
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How often are people in your household paid* This field is required.
Weekly
Biweekly
Monthly
Yearly
We do not currently earn income (including SSI, SSDI, interest, etc)
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Average amount per period* This field is required.
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Please select the documents you will use to verify financial status* This field is required.
SNAP/EBT (Electronic Benefits Transfer Card)
Temporary Assistance for Needy Families (TANF)
Social Security Disability Insurance or Supplemental Security Income (SSDI/SSI)
LIHEAP (Home Energy Assistance)
Employment Related Daycare ($0 Copay)
Oregon Health Plan
Paystubs or other income documents
Other
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Proof of Income and/or eligibility document upload* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Yearly Income* This field is required.
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Government Issued ID Number* This field is required.
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Government ID Photo Upload* This field is required.
Drag and drop files here
Select files to upload
Max. file size: 10.6MB
Cancelof
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Occupation* This field is required.
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Employer* This field is required.
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Marital Status* This field is required.
Single
Married
Divorced
Common Law or Civil Partnership
Prefer not to answer
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What payment method will you use for the deposit?* This field is required.Cherry, Scratchpay, CareCredit, or major credit/debit cards
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Demographic Information

The following questions are designed to help us better understand the community we serve and will not affect any eligibility for financial assistance or agreements.
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What gender do you identify as?* This field is required.
Male
Female
Non-Binary
Prefer Not to Say
Other
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Which of the following describes your racial or ethnic identity? Please select ALL that apply.* This field is required.
American Indian or Alaska Native
Asian
Black or African American
Latinx or Hispanic
Middle Eastern/North African
Native Hawaiian or Pacific Islander
White
Other
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How Old Are You?
18-24 years old
25-34 years old
35-44 years old
45-54 years old
55-64 years old
65-74 years old
75+ years old
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Do you receive deliveries from Meals on Wheels People?
YESNO
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Are you currently or have you ever served as a member of the United States Armed Forces?* This field is required.
Yes
No
Prefer not to answer
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Add Dependents (if any)
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Current treatment amount
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Velvet Assistance Fund Application* This field is required.This fund may be used to access funding for end-of-life care, which includes compassionate euthanasia and general cremation. Please see the full terms and conditions below.
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Velvet Assistance Fund Application* This field is required.This fund may be used once per year per household for an appointment for a doctor's exam. Repeat applications will be denied. Please see the full terms and conditions below.
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VAF Checksum
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Signature* This field is required.
Clear
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VAF Status:Will not be client facing at launch, used to store data
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vafThru
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