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Pet Mutual Aid Support
This form is specifically for families that are impacted by ICE across Minnesota. A member of our team will be in touch with you with next steps!
My Family or a family I am working with is currently impacted by ICE which is preventing access to fulfilling basic needs.
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Yes
No
I am in need of support with:
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Pet Food & Supplies (Pick Up/ Delivery)
Veterinary Care for my Pet(s)
Grocery Support (Pick Up/ Delivery)
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Pet Food Pick Up / Delivery
This form is for Mutual Aid Requests Only! We'll do our best to fill orders within 24-48 hours.
I am filling this form out for:
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Myself
Someone else
Form Filler Contact Name
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Form Filler Contact Email or Phone
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To coordinate delivery/pick up or if there are additional questions:
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Contact the FORM FILLER
Contact the PET OWNER directly
I would like this order to be:
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Picked up in person (2825 N 2nd St MPLS MN 55411)
Delivered (We only deliver within 20 miles of 2825 N 2nd St MPLS MN 55411)
Pick up orders only: Who will pick up the order?
Pick up orders only: Pick up person phone number.
Pet Owner Name:
First Name
Last Name
Pet Owner Contact Phone Number:
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We will use this to contact you with any questions & order updates
Pet Owner Email
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example@example.com
Delivery Address (only needed for deliveries!)
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Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
How many CATS are in the household?
What type of CAT FOOD would you like? (If 0 leave blank!)
Dry Cat Food
Wet Cat Food
Do your CATS have any allergies? Any food preferences?
Do you need CAT LITTER?
Please Select
Yes
No
How many DOGS are in the household? (If 0 leave blank!)
What is the TOTAL weight of your dogs?
If you have two 40 lb dogs = Total weight is 80 lbs.
What type of DOG FOOD would you like?
Dry Dog Food
Wet Dog Food
Do your DOGS have any allergies? Any food preferences?
Is there anything else that you need for your pets at this time?
Anything else you'd like us to know?
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Vet Care Support Request Form
Please fill out this form if your pet is experiencing a medical need.
Pet Owner Name:
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First Name
Last Name
Pet Owner Contact Phone Number:
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We will use this to contact you with any questions & order updates
Pet Owner Email:
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example@example.com
Name of Pet Needing Care
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What type of Pet
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Dog
Cat
Small Animal (hamster, guinea pig, rabbit etc)
Other
The issue my pet is having is the following color:
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RED
ORANGE
YELLOW
GREEN
My Pet Needs:
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Emergency Care / Urgent Care (I think something is urgently wrong with my pet)
Spay & Neuter Surgery
Papers to Travel to Another Country
Updated Vaccinations
Support with an Ongoing Chronic Illness
To Be Groomed
Other
What concern do you have about your pet? Please provide any and all details. (Our Access to Care Navigator will contact you to follow up)
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How long have you had this concern about your pet?
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Do you have a photo of the health concern you'd like to share with us?
Browse Files
Drag and drop files here
Choose a file
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of
If vet care is provided:
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I would be able to drive my pet to a clinic in Crystal, MN.
I would need my pet to be picked up and brought to the clinic in Crystal, MN & would need my pet to be dropped off after the visit.
I would need in home support.
I would be able to drive my pet to the North Minneapolis Pet Resource Center for care.
If vet care is provided I would need the following financial support options:
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A Payment Plan
A Pay What I Can Option
For My Visit to be Free
Unsure at this time
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Grocery Delivery/Pick Up Request
Please fill out this form if you would like to pick up groceries at North Minneapolis Pet Resource Center or if you'd like groceries delivered to your door.
Name
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First Name
Last Name
Email
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example@example.com
Phone Number
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Please enter a valid phone number.
How many Adults are in the Household?
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How many Children are in the Household?
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I will:
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Pick up my order at North Minneapolis Pet Resource Center
Need my order delivered to my doorstep
Are there any dietary restrictions or any allergies we should know about?
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Submit
Should be Empty: