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2. Program Eligibility Requirements

   To receive the one-time reimbursement assistance, the applicant must meet the following criteria:

   • Be a senior 62 years of age or older, receiving social security benefits.
   • Be a resident of the Village of Palmetto Bay
   • Only emergency vet services apply; routine services are excluded.

   Applications and support documents will be reviewed by staff upon submission.  Once the documentation has been approved, a reimbursement check will be mailed to the address provided on the online application.  

   Processing of the applications and reimbursement may take up to two weeks, depending on the number of applications received.

   If you have any questions, please send us an email.

4. First Name*

   Please enter the senior recipient's first name.

5. Last Name*

   Please enter the senior recipient's last name.

7. Email Address
8. Home or Mobile Number*
10. Home Address*
12. City*
13. State
14. Zip Code
16. Recipient's Age*

    Is the recipient 62 years of age or older?

    1. Yes
    2. No
17. Social Security Benefits*

    Is the recipient receiving Social Security benefits?

    1. Yes
    2. No
19. Residency*

    Does the recipient reside in the Village of Palmetto Bay?  Please note that a copy of the Driver's License is required to establish residency.

    1. Yes
    2. No
21. Pet's Name*
22. Pet Type
24. Emergency Service Received*
25. Service Date*
26. Service Cost*
28. Veterinarian Name*
29. Veterinarian's Phone Number*
31. Valid Driver's License*

    Please upload a copy of your valid driver's license as proof of residency in the Village of Palmetto Bay.

32. Social Security Administration (SSA) Letter*

    Please upload a copy of your Social Security Administration (SSA) letter showing that you are currently receiving social security benefits.

33. Veterinary Bill*

    Please upload a copy of the veterinary bill showing your name, the service provided and related costs.  A bill dated earlier than March 18, 2025 will not be accepted.

35. Initials*

    By providing your initials above, you hereby attest that the above-named pet belongs to and is under the care of the senior resident making this reimbursement request under the SAVE program.

37. Date and Time of Submission*
    Date and Time of Submission

    Date and Time of Submission
Leave This Blank:


41. 1. Receive an email copy of this form.
42. Email address

    This field is not part of the form submission.

43. Submit

* indicates a required field