Follow the steps to successfully complete your application.

1. Click ‘Get Form’ button to access the Mercy Pricing Application form and open it in the editor.
2. Begin by indicating your organization's 501C3 status if applicable. You will need to check the appropriate box that fits whether you can provide an IRS Letter, a 990 Form, or if you do not work with an organization.
3. Next, indicate your participation in any government assistance programs. You may choose from a list including disability income, food support, Medicaid, and others. Be sure to check all that are relevant to your situation.
4. Provide information about your household's gross annual income. Enter the total amount before taxes in the designated field and ensure it reflects the collective income of all earners in your household.
5. Indicate the total number of individuals living in your household, including all earners, non-earners, and dependents. This helps establish eligibility for the pricing application.
6. Review your information carefully to ensure accuracy. You will then affirm the truthfulness of your statements by signing and dating the form.
7. Once you have completed the form, save your changes. You may either download the document to email it to staff@mercypetclinic.org or print it to bring with you to your appointment.

Complete your Mercy Pet Clinic Mercy Pricing Application online today to secure your discounts.