Pet Intake Request Help us learn more about the pet you need to rehome. We will contact you if we are able to accept your pet. Name(Required) First Last Phone(Required)Email(Required) Enter Email Confirm Email Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Pet Type(Required) Dog Cat Select oneBreed(Required)(If unsure of pet’s breed, please include pet’s photo at bottom of form)Pet Name(Required) Do you own the pet?(Required) Yes No Select one How did you acquire this pet?(Required)Gender of Pet(Required) Male Female Approximate Age of Pet(Required)Has this pet been spayed/neutered?(Required) Yes No Unknown Select onePet’s Approximate Weight(Required)Please enter a number from 0 to 200.How long have you owned this pet?(Required)Tell us why you need to surrender this pet?(Required)Tell us about this pet’s behavior and personality(Required)Is this pet current on vaccinations and heartworm prevention?(Required) Yes No Unknown Select oneVet Clinic that administered vaccinationsTell us about any known medical concernsAdditional CommentsPet's Photo (1)Accepted file types: jpg, jpeg, png, gif.Pet's Photo (2)Accepted file types: jpg, jpeg, png, gif.Pet's Photo (3)Accepted file types: jpg, jpeg, png, gif.(1.) Pet Intake Request Policy(Required) I understand that I will ONLY receive a call if there is space to accept my pet(s).(2.) Pet Intake Request Policy(Required) I understand that there is not a “waiting list” for new animal intakes. If it has been longer than 4 weeks since I submitted my pet intake request, and have not received a call, I am welcome to submit another pet intake request if I still need to rehome my pet.
