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Network Veterinarian Membership Form

Thank you for your interest in joining the Scout's Fund Veterinary Network as a participating veterinarian. Our network is open to all certified veteranarians within Maine's midcoast region, Waldo, Lincoln and Knox counties. You can review the terms and conditions of membership at the bottom of the form. If you'd like more information, please contact us, and someone will get back to you promptly.

Name of Veterinarian

Name of Practice

Practice Address

Practice Phone Number

Practice Email

Practice Website (if applicable)

How long have you been practicing?

How long has the clinic been serving animals in midcoast Maine?

Types of animals served?

Approximate number of patients?

By submitting this application, I agree to Scout's Fund Network (SFN) requirements:

By submitting this application, I agree to the Scout's Fund Network member terms and conditions:

I agree to hang a plaque in my clinic waiting room signifying that I am an SFN Member.
I agree that I will provide any medications, supplies, equipment, etc. at cost for any dog for whom I request a grant and I will provide my services (and those of technicians and other employees) at a 10% discount of usual prices.

Thank you! Your membership request has been submitted. We will review your information and may be in touch with you if more information is needed. Do not hesitate to contact us if you have any questions (contact info below in footer.)