Eligibility Requirements

One Health Organization > We Can Help > People With Pets > Eligibility Requirements

ELIGIBILITY CRITERIA

In order to receive vouchers to help pay for veterinary care services, you must meet the following eligibility requirements:

  1. Live with a dog or a cat
  2. Fall under one of two criteria:
    1. at least 55 years of age, OR
    2. disabled, as defined by the federal government
  3. Have an income at or below 200% of the federal poverty rates.

2017 Federal Poverty Rates for Household Income

*Membership dues are based on monthly household income on a sliding scale, as indicated below. If you're unsure of how much your membership dues should be, please call the office at 216.920.3051 during normal business hours Monday through Friday from 8:30 m to 5:30 pm except observed holidays or send an email to OHFM@OneHealth.org. 

If you believe that you're eligible to receive vouchers, fill out the online application form below. You must also pay dues unless your household income is below 75% of the federal poverty rate. You can pay your annual dues in one of two ways. 

  1. Click to pay your dues by credit card.
  2. Send dues payment by mail. Make a check or money order out to "One Health Organization" with "OHFM Dues" in the Memo section and send to:

          One Health Organization
          ATTN: OHFM Dues

          27600 Chagrin Blvd, Ste 400
          Cleveland, OH 44122-4449

One Health Family Member Application Form

This form is for those seeking vouchers to help pay for veterinary care services. Understandably, due to the large number of requests for vouchers we cannot help everyone seeking financial assistance. Only eligible households can apply. Completing the application process with supporting documentation and payment does NOT guarantee that you will receive vouchers. Vouchers are distributed on a first come, first serve basis AND based upon the availability of funds for eligible households. New applicants can be place on a waiting for an unspecified period of time until more funds are raised.
  • Please list the applicant's information. This person must meet eligibility requirements. If a child or another household member with a disability is living in the home to meet eligibility requirements, then a parent or guardian must fill this out on their behalf and be considered the applicant.
  • To be eligible to receive vouchers your residence MUST be in Ohio AND in one of these seven counties: Cuyahoga, Geauga, Lake, Lorain, Medina, Portage, or Summit.
  • Please enter a value between 1 and 8.
  • To be eligible, every applicant must follow the eligibility criteria listed. Please choose all that apply.
  • All applicants MUST provide written proof of eligibility to receive vouchers! The first requirement requires written proof of any ONE of these: Provide proof of age 55+ (birth certificate OR driver's license OR state ID) OR proof of disability (letter from the Social Security Administration aka SSA). (Maximum file size is 64MB)
    Accepted file types: jpg, gif, png, pdf.
  • To be eligible, every applicant must be in financial need based on household income. Income must be no more than 200% of the current federal poverty rate.
  • The second requirement is to provide written proof of financial need. Upload any ONE of these documents that shows what you are receiving per month: *Social Security, *Disability Benefits, Pension/Retirement, Bank Statements, OR Paycheck Stubs. *Letters for pending social security and/or disability award benefits are NOT proof of income. (Maximum file size is 64MB)
    Accepted file types: jpg, gif, png, pdf.
  • If there are no dogs living with you, enter the number "0"
  • If there are no cats living with you, enter the number "0"
  • Drop files here or
    Accepted file types: jpg, gif, png, pdf.
  • Choose one option
  • Some veterinary clinics have strict payment policies and will not provide any more services to you until you pay them what you owe. This is understandable. We simply want to know your situation better.
  • Thank you for filling out this form. By hitting the submit button, you certify that what you provided is truthful to the best of your knowledge. Fraud is not tolerated at One Health Organization.