PICK-UP REQUEST & RELEASE FORM

ANIMAL PICK-UP REQUEST & RELEASE FORM
This form is used to request animal pick-up services provided by Paws Place Rescue Inc. Submission of this form does not guarantee pick-up and is subject to availability, safety, and rescue capacity.
Pick-Up Service Fee: A non-refundable fee of $50 is required for animal pick-up services. This fee helps offset fuel, equipment, and labor costs and does not constitute an adoption or surrender fee.
Animal Information
Animal Type (Dog/Cat/Other):
Breed (if known):
Color / Markings:
Approximate Age:
Sex:
Spayed / Neutered:
Known Medical or Behavioral Concerns:
Is the animal aggressive or fearful?:
Pick-Up Location
Pick-Up Address:
City / State / Zip:
Is the animal contained?:
Best Time for Pick-Up:
Requestor Information
Full Name:
Phone Number:
Format: (000) 000-0000.
Email Address:
example@example.com
By signing below, I acknowledge that the $50 pick-up fee is required prior to service and is non-refundable. I understand that Paws Place Rescue Inc. is not an animal control agency and may decline or delay pick-up based on safety, capacity, or animal condition. I release Paws Place Rescue Inc. from liability related to the condition or outcome of the animal once pick-up has occurred.
Requestor Signature:

Clear
Date:

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ANIMAL PICK-UP REQUEST & RELEASE FORM