Case confirmation

Confirm an application

Use this form to confirm the details of a Pet Aid Manitoba applicant. We'll have already been in touch about the application — fill in what you can verify from your end.

Only confirm details you can verify from your clinic records. If anything doesn't match, add a note at the bottom and we'll follow up.

Your clinic

Clinic name *

Clinic email *

Patient information

As provided by the client and confirmed from your records.

Pet owner's name *

Pet's name *

Medical details

Confirmed diagnosis *

Recommended treatment *

Confirmed cost estimate *

Please provide the most accurate estimate you can at this stage.

How urgent is this case? *

Confirmation

Were you able to verify the pet owner's identity? *

Additional notes (optional)

Supporting documents

Upload any relevant records to support this confirmation. Accepted formats: PDF, JPG, PNG. Max 10MB per file.

Diagnosis or clinical notes

Any documentation confirming the diagnosis.

Cost estimate or invoice

A written estimate or preliminary invoice for the treatment.

Confirmed by

Full name *

Clinic role *

This is for our records only and will not be shared publicly.

We'll follow up by email once we've reviewed your confirmation.

Clinic portal

Confirm an application

Your clinic

Patient information

Medical details

Confirmation

Supporting documents

Confirmed by

Confirmation received

Updates & approvals

Look up an approval

Billing

Program notices