The Frankie Wheelchair Fund Application

The Frankie Wheelchair Fund Application

Please copy and past this questionnaire into a word document and then complete. Once completed, email to barb@joyfulpaws.com. There is no guarantee that by filling out this questionnaire that we can provide funds for a wheelchair. But we will certainly see how we can best help.

We are not a non-profit, therefore donations are received as others hear about the work we do, so funds can be low or depleted at times- it just all depends. But again, if we can help, we will try our best to do that.

IMPORTANT: Along with this completed form you must also send verification from your vet on diagnoses and prognosis. Please have them email to us on their company letterhead. We may also require for them to call us.

Also, this is first come, first serve. So if we have some funds available, as well as the order in which we receive requests, is how we base who we can help, along with qualifications from your answers below.

Please allow us 2-5 days to review your application.

PLEASE NOTE:  If your application is approved you will need to call in measurements for your dogs wheelchair to Eddie’s Wheels within 7 business days. If they don’t receive them by then your request for funds will go to the bottom of the waiting list. Because this is first come, first serve, and we often have others needing a wheelchair, we must adhere to this. Thank you for understanding.

Your full name:________________________________________________________________________
Address, City, State: ____________________________________________________________________
Phone:_______________________________________________________________________________
Email:________________________________________________________________________________

How old is your dog? What is his or her name?
_____________________________________________________________________________________
What is the breed?
_____________________________________________________________________________________
What is the diagnosis?
_____________________________________________________________________________________

____________________________________________________________________________________

If diagnosis is IVDD what do you know about this disease?
_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

What treatment have you done? Is he/she on a current treatment plan?
_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

What is prognosis?
_____________________________________________________________________________________

_____________________________________________________________________________________

If this is IVDD when did your dog go down (when did you notice something was wrong?) When did he/she see vet?
_____________________________________________________________________________________

_____________________________________________________________________________________

Did you do surgery or conservative treatment?
_____________________________________________________________________________________

_____________________________________________________________________________________

If conservative treatment, how long have you been doing?
_____________________________________________________________________________________

_____________________________________________________________________________________
If you opted for surgery, when was the surgery?
_____________________________________________________________________________________

_____________________________________________________________________________________

Does your dog have bladder and bowel control?
_____________________________________________________________________________________

_____________________________________________________________________________________

If your dog has been diagnosed with IVDD, do you know about www.dodgerslist.com?
_____________________________________________________________________________________

If so, have you reached out to them for help? If so, please explain what they have advised you to do.
_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

Please explain your reason for contacting us in regards to a wheelchair? What is your financial situation? We ask that you are honest in sharing this information.
_____________________________________________________________________________________

_____________________________________________________________________________________

What can you contribute toward the wheelchair? Are you willing to do a fundraiser or tag sale to try and raise funds? We ask for your complete honesty with this question. The funds can be limited at times, so we ask that whatever you can pay toward the wheelchair so that the fund can help as many pets as we can.
_____________________________________________________________________________________

_____________________________________________________________________________________
Have you checked into the cost of a wheelchair and if your dog is a good candidate for one? You will need to call and talk with Eddie’s Wheels (1-888-211-2700) as not all dogs are candidates for various reasons. Along with this completed application, and information from Eddie’s Wheels, and letter from your vet is the process in determining if funds for a wheelchair can be provided from the Frankie Wheelchair Fund.
_____________________________________________________________________________________

_____________________________________________________________________________________

Lastly, should your dog walk again after getting a wheelchair (or when they pass away) we require that the wheelchair be donated back to Eddie’s wheels so that it can help another pet.
 Please check box that you agree to donate wheelchair back to Eddie’s Wheels when you no longer need it.
We also ask that should we be able to help your dog with a wheelchair that your provide us with a photo of your dog in their wheelchair. This photo is posted on our website and Facebook so our contributors are kept up to date on pets we have helped.
 Please check box that you agree to submit photo.
Please sign below that you are verifying that the information you have provided us is honest and to the best of your knowledge.

_______________________________________________ _____________________________________
Signature                                                                                                              Date

8 Responses to The Frankie Wheelchair Fund Application

  1. Cyndi Pellish says:

    I thank you for the opportunity to be able to apply for help

  2. […] If you’d like to make a donation and/or become an ambassador helping us help dogs in need of a wheelchair, please click on the heart below. Or if you’d like to apply for the fund, please click here. […]

  3. […] With that in mind, you might want to help some of the organizations that help provide wheelchairs for dogs. Barbara Techel and her group Joyful Paws operate the Frankie Memorial Fund, which collects money to buy chairs for dogs whose owners might otherwise not be able to afford them. Note that the Frankie Memorial Fund is not a 501(c)(3), so donations are not tax-deductible. Those who want to apply to receive fund from the fund can do so here. […]

  4. […] With that in mind, you might want to help some of the organizations that help provide wheelchairs for dogs. Barbara Techel and her group Joyful Paws operate the Frankie Memorial Fund, which collects money to buy chairs for dogs whose owners might otherwise not be able to afford them. Note that the Frankie Memorial Fund is not a 501(c)(3), so donations are not tax-deductible. Those who want to apply to receive fund from the fund can do so here. […]

  5. […] With that in mind, you might want to help some of the organizations that help provide wheelchairs for dogs. Barbara Techel and her group Joyful Paws operate the Frankie Memorial Fund, which collects money to buy chairs for dogs whose owners might otherwise not be able to afford them. Note that the Frankie Memorial Fund is not a 501(c)(3), so donations are not tax-deductible. Those who want to apply to receive fund from the fund can do so here. […]

  6. […] With that in mind, you might want to help some of the organizations that help provide wheelchairs for dogs. Barbara Techel and her group Joyful Paws operate the Frankie Memorial Fund, which collects money to buy chairs for dogs whose owners might otherwise not be able to afford them. Note that the Frankie Memorial Fund is not a 501(c)(3), so donations are not tax-deductible. Those who want to apply to receive fund from the fund can do so here. […]

  7. […] take the funding very seriously and have an application process in place. Not everyone is approved, but I feel the process I have is needed and fair. If […]

  8. […] If you’d like to help disabled dogs like Canelo experience living life to the fullest who are in need of a wheelchair to do so you can donate here.  Or if you are in need of help, you can fill out an application here. […]

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