FOOD ASSISTANCE PROGRAM
Welcome to Companion Pets of Cleveland Food Assistance program.

Your membership allows a monthly pickup of dry and or wet food for your pet(s) for one year.  Because we are donation-based, we cannot promise specific food types or name brands.  Pick-ups are on the 2nd and 4th Saturday of the month beginning April 2022.

The application you will fill out has many questions regarding you and your pets. There are no judgments, and the statistical information provided from your answers will be used in the future to secure grant funding, partnership opportunities, spay/neuter program expansion, additional public service opportunities, etc..

We will contact you once the application is received to schedule an appointment to pick up pet food. Please be prepared to provide a photo ID and a photo of your Governmental income.   You will receive a welcome letter and a resource sheet at your first pick up.

When you need more food please use our Food Assistance Reorder form via the Companion Pets of Cleveland website.  If food availability becomes an issue, you will be given a Resource guide that lists many services available in the Northeast Ohio area.

VIP Petcare administers both cat and dog vaccines at their office once a month: FVRCP, and Bordetella.  They insert Microchips and do Heartworm tests for dogs and FeLv/FIV tests for cats.  

TRANSPORTATION: It is your responsibility to have reliable transportation to the pantry.  If their are extenuating circumstances, please discuss them with a CPOC representative.  

We believe in this program and would like to see it continue!

Bob Stevens
Founder, Executive Director

Carol Rini
Food Assistance Program Chair

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I WAS REDIRECTED HERE FROM THE REORDER FORM. 
I AM FILLING OUT A NEW APPLICATION BECAUSE I RECENTLY HAD SOME CHANGES IN MY HOUSEHOLD; i.e. NEW ADDRESS, NEW PHONE, NEW e-MAIL, NEW PET.   
*
Required
I ONLY need VIP Petcare services (Vaccines, Microchip, etc.)  I DO NOT need pet food assistance at this time. *
Required
NAME (Legal Owner) *
STREET # and NAME (Photo ID Required) *
CITY, STATE & ZIP *
EMAIL ADDRESS *
PHONE:  HOME or CELL *
CAN WE TEXT THIS NUMBER *
HOW WOULD YOU LIKE TO HEAR FROM US PRIMARILY? *
GOVERNMENT ASSISTANCE (SELECT ALL THAT APPLIES) (Photo Proof Required) *
Required
ARE YOU A MILITARY VETERAN? *
HOW DO YOU IDENTIFY? *
AGE RANGE *
NAME OF PET #1 *
SPECIES OF PET #1: *
Required
GENDER of PET #1: *
Required
APPROX. AGE OF PET #1: Years, Months or Weeks? *
APPROX. WEIGHT OF PET #1: *
BREED of Pet #1: Tabby, DLH, DMH, DSH, Calico, etc.? *
COLOR of Pet #1 *
IS PET #1: *
Required
I UNDERSTAND THAT AS OF 8/1/2022 MY PET MUST BE SPAYED OR NEUTERED PRIOR TO RECEIVING VIP VACCINATION SERVICES. *
Required
CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE.  Select ALL that apply: *
Required
WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR?  IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS. *
Required
NAME of PET # 2:
SPECIES of PET #2:
GENDER of Pet #2:
APPROX. Age of Pet #2: Years, Months or Weeks?
APPROX. WEIGHT of PET #2:
BREED of Pet #2: Tabby, DLH, DMH, DSH, Calico, etc.?
COLOR of Pet #2
IS PET #2:
I UNDERSTAND THAT AS OF 8/1/2022 MY PET MUST BE SPAYED OR NEUTERED PRIOR TO RECEIVING VIP VACCINATION SERVICES.
CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE.  Select ALL that apply:
WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR?  IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.
NAME of PET #3
SPECIES of PET #3:
GENDER of Pet #3:
APPROX. Age of Pet #3: Years, Months or Weeks?
 APPROX. WEIGHT of Pet #3:
BREED of Pet #3: Tabby, DLH, DMH, DSH, Calico, etc.?
COLOR of Pet # 3
Is Pet #3:
I UNDERSTAND THAT AS OF 8/1/2022 MY PET MUST BE SPAYED OR NEUTERED PRIOR TO RECEIVING VIP VACCINATION SERVICES.
Clear selection
CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE.  Select ALL that apply:
WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR?  IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.
NAME of PET #4
SPECIES of PET #4
GENDER of PET #4
APPROX. Age of Pet #4: Years, Months or Weeks?
 APPROX. WEIGHT of Pet #4:
BREED of Pet #4: Tabby, DLH, DMH, DSH, Calico, etc.?
COLOR of Pet # 4
Is Pet #4:
Clear selection
I UNDERSTAND THAT AS OF 8/1/2022 MY PET MUST BE SPAYED OR NEUTERED PRIOR TO RECEIVING VIP VACCINATION SERVICES.
CPOC IN PARTNERSHIIP WITH VIP PETCARE OFFERS VACCINATIONS, MICROCHIPS & MORE FREE OF CHARGE.  Select ALL that apply:
WAS THIS ANIMAL VACCINATED WITHIN THE LAST YEAR?  IF SO, WE'LL REQUEST A COPY OF THOSE VACCINE RECORDS.
ADDITIONAL PET's (Please include name, species, weight, age, spay/neutered, breed) If no use N/A. *
VETERINARIANS NAME & PHONE NUMBER: If No use N/A *
WHAT DO YOU NEED? (Select All That Apply) *
Required
Do any of your pets require a special diet or on a medicated food?  If no use N/A: *
Do you need any pet accessories; collars, leashes, harnesses, food bowls, litter box w/scoop, etc.?          (We cannot guarantee that we'll have the item you need at the time of your request it.) If no use N/A. *
HOW DID YOU HEAR ABOUT CPOC? *
Any additional information you wish to share?  If no use N/A: *
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