SURRENDER FORM/WAITLIST APPLICATION
Please note this application and waitlist does not automatically guarantee we can take your pet. We recommend getting your name on multiple waitlists as most shelters are at full capacity. We currently have no estimated amount of time on when we can complete the intake. We will be in touch if/when we have room for your animal.
Main Contact
First Name
Last Name
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
E-mail
example@example.com
Cat or Dog
Breed of Animal
Gender
Please Select
Male
Female
Age
Name of Animal
Is the animal spayed or neutered?
Yes
No
Is the animal up to date on vaccinations? If so, please provide Veterinarian Name.
Does the animal have any food allergies?
Does the animal have any medical concerns?
How long have you owned the pet?
Reason for rehoming?
Is the animal housebroke and/or litter box trained? Please provide details.
Good with kids? Please provide details.
Good with dogs? Please provide details.
Good with cats? Please provide details.
Does the animal stay primarily indoors or outdoors?
If the animal is a dog, is the dog kennel/crate trained? Please provide details.
Please provide any additional information that would help us set your pet up for success.
By signing the form below, you acknowledge the information listed is accurate to the best of your knowledge. You also understand that you reliquish all of your rights of the animal listed above to Almost Home Humane Society should they accept your pet.
Name
Save
Submit
Good work! You're finished! Just press the submit button below and we'll be on our way.
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