Enrolling As A New Client
Please complete the form below to request enrollment to be eligible for supplies and services through the Jax Project. Enrollment must be referred by a human services or healthcare professional. By submitting the form, you agree that your provider may be contacted for verification of referral.
All enrollment requests will be reviewed within five business days and you will be notified of your enrollment status. Upon review, you may be contacted for supporting documents to complete your enrollment. Please view the program guidelines page for more information on client responsibilities and what the Jax Project can help with.
In the event you don’t qualify for services with the Jax Project, we may be able to point you towards other community programs that could benefit you and your pet! If you have any questions or concerns, please reach out to firstname.lastname@example.org and we can work with you to make sure your pets needs are covered!
Please complete the form below. Completed forms will be reviewed within five business days, and you will be notified of your status by email.
Upon review, you may receive a request for supporting documents in order to complete your application.