Intake Request Form
I am the owner or authorized agent/designee for the owner of the animal described below.
*
Yes
The information provided in this questionnaire is accurate and true to the best of my knowledge.
*
Yes
I understand that by submitting this questionnaire, it does not guarantee an appointment to surrender my animal(s) to Happy Hounds Animal Rescue.
*
Yes
Your Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Animal(s) Information
Are you looking to surrender a litter of puppies or kittens?
Yes
No
How many puppies/kittens are in the litter you are wishing to rehome?
Pet's Name (if applicable)
Species
*
Cat
Dog
Breed
*
Estimated Age and/or Birthday
*
Photo of the Animal
*
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Gender and Spay/Neuter Status of the animal
*
male/intact
male/neutered
female/intact
female/spayed
Is the animal vaccinated?
*
Yes, and they are up-to-date.
Yes, but they are out of date.
No
Unknown
If there are any known behavior issues with the animal please list them here. This allows us to ensure we can find the appropriate foster for the animal.
*
Are there any known health conditions or concerns for this animal?
*
Happy Hounds Animal Rescue is a foster based animal rescue with no facilities. Would you be willing to foster the animal until they can be re-homed? A specific time frame cannot be given for how long this will take because it varies.
*
Yes
No
Personal Pet Information
Please put NA if this animal is a stray.
How long have you had your pet?
*
What is your reason for re-homing?
*
If assistance can be provided for you, would you like to keep your pet?
*
Yes
No
NA
Where did you get your pet from? Please, be as specific as possible.
*
Where has your pet been living primarily?
*
Have you taken any measures to remedy the reason for re-homing your pet?
*
Yes
No
NA
Is your pet microchipped?
*
Yes
No
NA
Veterinarian Clinic (name & contact information)
*
Stray Animal Information
Please put NA if it is a personal animal.
Date animal was found
*
Closest cross streets where the animal was found (Ex: Home St.and Market St.)
*
Is the animal microchipped?
*
Yes
No
NA
If microchipped was the owner contacted?
*
Yes, no response from owner
The microchip was not registered.
No
The animal is not microchipped.
The animal was not checked for a microchip.
NA
If the animal was wearing a collar when found please describe its color and fabric style or put no collar.
*
Please provide a description of the animal and any unique characteristics.
*
Submit
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