Apply for Vouchers

One Health Organization > We Can Help > Pet Parents > Apply for Vouchers

APPLY FOR VOUCHERS

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

  1. Live with a dog or a cat in Cuyahoga County or adjacent counties in Northeast Ohio (Lake, Geauga, Portage, Summit, Medina or Lorain)
  2. A household member must 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 guidelines

2020 Federal Poverty Measures for Household Income

Membership dues are deducted from the value of Vouchers you receive, as indicated in the table below. If you're confused about this policy, 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 us an email. These rates change every January when the Federal Government publishes the annual federal poverty guidelines.

# People in the Household

At or below 75% 76-100% 101-125% 126-150% 151-175% 176-200%
1 $0-797 $797.01 - 1,063  $1,063.01-1,329  $1,329.01-1,595  $1,595.01-1,861  $1,861.01-2,127
2 $0-1,078  $1,078.01-1,437  $1,437.01-1,796  $1,796.01-2,155  $2,155.01-2,514  $2,514.01-2,873
3 $0-1,358  $1,358.01-1,810  $1,810.01-2,263  $2,263.01-2,715  $2,715.01-3,168  $3,168.01-3,620
4 $0-1,637  $1,637.01-2,183  $2,183.01-2,729  $2,729.01-3,275  $3,275.01-3,821  $3,821.01-4,367
5 $0-1,918  $1,918.01-2,557  $2,557.01-3,196  $3,196.01-3,835  $3,835.01-4,474  $4,474.01-5,113
6 $0-2,477  $2,477.01-2,930  $2,930.01-3,663  $3,663.01-4,395  $4,395.01-5,128  $5,044.01-5,765
7 $0-2,758

 $2,758.01-3,303

 $3,303.01-4,129  $4,129.01-4,955  $4,955.01-5,781  $5,781.01-6,607
8 $0-3,038  $3,038.01-3,677  $3,677.01-4,596  $4,596.01-5,515  $5,515.01-6,434  $6,434.01-7,353
*Membership Dues Waived $5.00 $10.00 $20.00 $30.00 $40.00
Voucher Amount After Dues are Deducted $250.00 $245.00 $240.00 $230.00 $220.00 $210.00

 

If you believe you're eligible to receive Vouchers, fill out the online application form below.

Please do not print the online application below! If you need a paper application to be mailed to you, please call the office at 216.920.3051 option #1 during normal business hours Monday through Friday from 8:30 m to 5:30 pm (except observed holidays). Leave a message if no one can answer the phone. Your call will be returned as soon as possible.

You can mail your paper application form and written proof of eligibility to:

          One Health Organization
          ATTN: OHFM Vouchers

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

One Health Family Member & Voucher 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 may 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-served basis AND based upon the availability of funds for eligible households. Applicants may be placed on a waiting list 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 you MUST live in Ohio AND in one of these seven counties at the time you apply: Cuyahoga, Geauga, Lake, Lorain, Medina, Portage, or Summit.
  • Check all that apply to the address above
  • Enter the best phone number where you can be reached during normal business hours (8:30 am to 5:30 pm, Monday through Friday)
  • Enter the number of people living in your household, including you.
    Please enter a number greater than or equal to 1.
  • 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. Provide of any ONE of these documents: 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). You may send a copy of your documentation by mail.
    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. PLEASE SUBMIT FINANCIAL DOCUMENTS FOR THE CURRENT CALENDAR YEAR! 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. *Please note that letters for pending social security and/or disability award benefits are NOT proof of income. A copy of your proof of income may be mailed.
    Accepted file types: jpg, gif, png, pdf.
  • Enter the total number of dogs living in your home. If there are no dogs living with you, enter the number "0"
  • If you have any dogs living with you, please tell us their name, breed (if known), coat color, age or date of birth (if known), male or female, etc.
  • If there are no cats living with you, enter the number "0"
  • If you have any cats living with you, please tell us their name, breed (if known), coat color, age or date of birth (if known), male or female, etc.
  • 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.
  • If you are able, please upload a photo of your pet that we can use for fundraising purposes. We'd also like for you to be in the photo. Your privacy will be maintained. (No more than four photos.)
    Drop files here or
    Accepted file types: jpg, gif, png, pdf.
  • Please share your story of why you need Vouchers, what your pet means to you, how you are feeling because you cannot afford veterinary care, or anything else you believe we can share with others for fundraising purposes. As always, your privacy will be maintained.
  • Thank you for filling out this form. By hitting the submit button (please only click once!), you certify that what you provided is truthful to the best of your knowledge. Fraud is not tolerated at One Health Organization.


Vouchers can be used for most veterinary care goods and services. Be aware that $250 should cover veterinary care needs for one healthy pet needing an annual wellness visit that requires a physical exam, some disease tests (e.g. heartworm test for dogs, FIV/FeLV test for cats, and fecal exams), and core vaccinations (annual shots for adult dogs and cats). Keep in mind that if you have a sick pet, costs for tests and treatments may be higher than $250.

Vouchers may NOT be used for:

  1. routine spay and neuter to reduce unwanted pregnancies
  2. tail docking and ear cropping to meet breed standards
  3. goods and services that aren't medically or surgically necessary for your pet's health (or for your health benefit), such as microchipping, collars, leashes, toys, etc.