Emergency Pet Care - Intake Form

This Owner Agreement sets out the terms and conditions under which The Stay Foundation Ltd agrees to provide temporary care for your pet(s) through one of our approved boarding partners or, where available, an approved foster carer.

By signing this agreement, you acknowledge that you have read, understood and agree to be bound by the terms and conditions contained in this document. These terms form a legally binding agreement between you and The Stay Foundation Ltd. If you do not understand any part of this agreement, please contact us before signing.

Please complete this form as accurately and honestly as possible. The information you provide enables us to assess your application, ensure the safety and welfare of your pet(s), and provide the most appropriate care during their stay with us.

Responsible Pet Ownership Requirements

As part of our commitment to responsible pet ownership and improving animal welfare, it is an essential condition of this agreement that all pets accepted into The Stay Foundation's Temporary Pet Care Program meet the following requirements:

Desexed – Desexing helps prevent unwanted litters and reduces the risk of a number of serious health and behavioural issues. If your pet is not already desexed, you acknowledge and agree that your pet will be desexed while in The Stay Foundation's care.

Vaccinated – Vaccinations protect pets against serious and potentially fatal diseases, including Parvovirus, Canine Distemper, Feline Enteritis and Cat Flu. If your pet is not currently vaccinated, vaccinations must be completed before entering our boarding program, as this is a mandatory requirement of our boarding partners.

Microchipped and Registered – Microchipping and lifetime registration are legal requirements in New South Wales and are essential for identifying and reuniting lost pets with their owners. If your pet is not already microchipped, you acknowledge and agree that your pet will be microchipped while in The Stay Foundation's care.

Where required, The Stay Foundation will arrange for these mandatory veterinary services to be carried out on your behalf by one of our approved veterinary partners.

Overview of situation

Is your situation one where you have no family members or trusted friends available to care for your pet(s) during your time of crisis, and you are unable to afford a pet sitter or private boarding?

Referring agency and contact details including caseworker's name, phone number and email

Owner's Name

First NameLast Name

Owner's Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Owner's Emergency contact/relationship to Owner:

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Please provide proof of residence and identification by uploading a copy of your Driver's License or proof of residence such as a copy of a household service bill , phone bill, council rates (in your name at your current address) etc

Are you a Housing NSW Resident?

Are you currently on a pension or receiving Centrelink benefits?

Please upload a copy of your Pension card or proof of receipt of Centrelink benefits

Why are you seeking care for your pets?

How long does your pet require emergency care for?

If care for your pet is required for respite/hospital care, please upload a copy of your admission confirmation letter from the hospital showing all admission and discharge dates

Can your pet(s) photo be shared publicly on our social media and for advertising purposes? Please note names will be changed to protect privacy.

Can you transport your pet(s) to and from the kennels/foster care

The Stay Foundation will provide up to two weeks kennel boarding with one of our partners, however we do require a non refundable contribution to be paid. Are you able to pay a contribution towards their stay?

Pet's name

Type of pet

Sex

Age of pet/DOB

Weight of pet if known

Breed

Colour of pet

Contact details of your pet's usual veterinarian

Is your pet desexed?

If your pet is desexed, please upload a copy of their desexing certificate or details of the vet who performed the desexing.

Details of vet who performed desexing

If your pet is not already desexed, this will be arranged once they enter our care, as desexing is an essential condition of this agreement. By signing this agreement, you are providing consent for your pet to be desexed while in our care, without further notice to you.

It is also a mandatory requirment of our program, as well as a non negotiable requirement of our kennelling partners, that your pet is also up to date with all vaccinations as well as microchipped and registered with your local Council.

If not already done, this will be done whilst your pet is in our care and/or before they enter kennelling.

Do you understand and acknowledge that, if your pet is accepted into care and it is not already desexed, it will be desexed while in our care without further notice to you?

If your pet is female and they are not desexed are they on heat?

If no, what date was their last heat?

If your pet is male, have both testes descended?

If your pet is undergoing desexing surgery, have they been well over the last 14 days?

Is your pet vaccinated? If so which one? Dog C5, C3. Cat F3, F4

Please upload a copy of the last vaccination certificate or provide details of the vet who administered the vaccination

Details of the vet that provided the vaccination.

If you have a cat coming into care, is it FIV positive?

Is your pet microchipped?

Microchip number:

Is the microchip in your name?

Is the pet registered in your name?

If not, who's name is the pet registered in?

Is your pet registered with a Local Council?

What Council is your pet registered in?

If you have a dog coming into care, is there a current dangerous dog order or has there been?

Are your pet's monthly preventative tick, flea, worm etc up to date?

Is your pet currently taking any medications? If yes what type?

Is your pet toilet trained?

What does your pet usually eat?

What treats does your pet like?

Has any food caused problems?

Does your pet have food aggression?

Where does your pet usually sleep?

Have you ever had your pet/s in care before? If so where?

Can you give us any more information that would be helpful in caring for your pet?

Does your pet have any behavioral issues? Destructive? Dig holes? Barks or howls? Escapes from the yard? If yes please describe:

Does your pet usually live in a house, apartment, unit, rural or other?

Is your pet accustomed to children? Have they ever been aggressive towards children or people in general?

Does your pet relate well and friendly with other animals? What animals have they lived with before?

If you have a dog, is the dog well behaved on a leash walking in public?

How many hours a day are your pets accustomed to having company?

The Stay Foundation's mission is to ensure that families and their pets STAY together. Do you confirm that, at the conclusion of your pet's agreed kennel/foster stay, your pet will be returned to your care and that you have suitable accommodation?

Please provide the address where your pet will be returned upon completion of their stay with The Stay Foundation. If this address is expected to change during your pet's stay, you must notify The Stay Foundation as soon as possible.

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

By signing this application, I acknowledge and agree to the following:

1. I confirm that I am over 18 years of age, the legal owner of the pet listed above, and that all information provided is true and accurate to the best of my knowledge.

2. I hereby indemnify The Stay Foundation Limited, its staff, volunteers and all agents against all actions, court proceedings, claims, demands for damages compensation, cost, or otherwise arising out of or in respect of The Stay Foundation Limited providing emergency accommodation, including any vet care given.

3. In consideration of The Stay Foundation Limited providing such emergency accommodation, I agree that I will not make any claim or demand against The Stay Foundation or any of its staff, volunteers or agents, for anything arising out of or in connection with The Stay Foundation Limited providing such emergency accommodation for my animals.

4. I understand that if my pet(s) are accepted into foster care, The Stay Foundation will desex my pet(s), that are not already desexed, whilst they are in care without further notice to me and that this desexing policy is and essential condition of this agreement.

5. By signing this agreement, I acknowledge and agree that the desexing requirement is an essential term of this contract. If I withdraw my consent to the desexing of my pet(s) after acceptance into the program, I may be in breach of this agreement. In those circumstances, The Stay Foundation may terminate this agreement, my pet will be returned to me or my emergency contact (if safe to do so) and I may be liable for any reasonable costs and expenses incurred by The Stay Foundation up to the date of termination, including boarding, veterinary, transport, food, administration and any other costs reasonably incurred in reliance on this agreement.

6. I understand that The Stay Foundation reserves the right to cancel or postpone any veterinary procedure at its discretion and without prior notice.

7. I give consent to the Stay Foundation and its veterinary partners to provide vet care to my pet including desexing, vaccination and microchipping.

8. I acknowledge the risks associated with anaesthesia and surgical procedures. I understand that only a basic pre-anaesthetic evaluation (excluding blood tests) will be performed and accept the risks associated with any undetected underlying conditions.

9. I accept that The Stay Foundation covers only the procedure listed in this application and is not liable for any complications (including death or permanent injury) or associated costs that may arise during or after surgery.

10. I understand that any medical conditions identified during examination or surgery will be communicated upon discharge, and that no additional treatments will be provided under this program. Any further treatment required is my sole responsibility.

11. I agree to cover any costs not explicitly approved in writing by The Stay Foundation.

12. I accept full responsibility for providing appropriate post-operative care, including adequate food, water, shelter, and monitoring of my pet during recovery.

13. I understand that failure to follow the post-operative care instructions may result in complications for which The Stay Foundation is not responsible, financially or otherwise.

14. I agree to release, indemnify, and hold harmless The Stay Foundation, its staff, veterinarians, and volunteers from any and all claims, damages, injuries (including death), or losses arising from or connected to the services provided.

15. I hereby authorise the veterinarian engaged by The Stay Foundation to perform the procedure listed and consent to treatment as described under the terms of this waiver.

16. I acknowedge that it is The Stay Foundations mission to ensure that families and their pets STAY together and I confirm that at the conclusion of my pet(s) agreed stay, my pet(s) will be returned to me and that I have suitable accommodation.

17. If we have not been able to contact you or your nominated emergency contact within three (3) weeks after the agreed end date of your pet(s)'s stay, despite reasonable attempts to do so, your pet(s) will be considered abandoned. By signing this agreement, you acknowledge and agree that, in these circumstances, you consent to The Stay Foundation taking all necessary steps to rehome your pet in its best interests, without any further notice to you.

18. By signing this agreement, you acknowledge that you have read, understood and agree to be bound by the terms and conditions contained in this document. These terms form a legally binding agreement between you and The Stay Foundation Ltd. If you do not understand any part of this agreement, please contact us before signing.

I have read, understood, and agree to the terms outlined above.

Did you require assistance in completing this form

If yes, please provide the name of the person who assisted you in completing this form and their relationship to you

Signature

Date

We will be in touch as soon as possible via email to advise of next steps. Please ensure you check your spam/junk email folders if you have not received a response.