Foster Initial Intake Form
ATTENTION! This Form is for INITIAL INTAKE of a New Animal. Please Complete and Submit Form Immediately upon taking in a NEW Animal. If the animal is an Owner Surrender or Returned Adoption - You do not need to complete this form.
Name of Foster submitting Intake
*
First Name
Last Name
Do you Have a New Address Since Last Intake?
Yes
No
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Foster Email - you will be sent a copy
*
example@example.com
Intake Date
*
-
Month
-
Day
Year
Date
How was pet acquired
*
Stray off the street
Pulled from Shelter
Returned adoption
Puppy/kitten from pregnant foster pet
Other Rescue
Independant Rescue
Other
Name of Shelter
Animal ID from Shelter
Pictures of Shelter/Rescue Paperwork
*
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Include Pictures of ALL Records from Shelter
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Pictures of Shelter/Rescue Medical Paperwork
*
Browse Files
Include Pictures of ALL Records from Shelter
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Name of Rescue (Transfers)
If Stray, Where found: City, Zip Code and Cross Streets
*
PLEASE Include City and Zip Code
What Species are you Intaking?
*
Dog
Cat
Other
Tell us if this is a Litter or Single Intake?
*
Multiple Pets: Littermates
Multiple Pets: Strays or Abandoned
Single pet
How Many Animals are being Intaked?
*
Please Select
1
2
3
4
5
6
7
8
9
10
Animal 1
Animal 1 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 1
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Animal 2
Animal 2 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 2
Browse Files
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Animal 3
Animal 3 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 3
Browse Files
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Animal 4
Animal 4 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 4
Browse Files
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of
Animal 5
Animal 5 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 5
Browse Files
Cancel
of
Animal 6
Animal 6 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 6
Browse Files
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of
Animal 7
Animal 7 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 7
Browse Files
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of
Animal 8
Animal 8 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 8
Browse Files
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of
Animal 9
Animal 9 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 9
Browse Files
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of
Animal 10
Animal 10 Name
*
If not named, put Breed
Sex
*
Male
Female
Est. Age
*
DOB or Est. Age
Breed of Animal (if unsure, best estimation)
*
ie - Husky/Mix, Pit Bull
Spayed/Neutered
*
Please Select
Yes
No
Unknown
Est. Weight
*
ie 15lbs or 9oz
Color/s Description
*
Brief Color Description (ie Black, Tan with white face)
Picture - Animal 10
Browse Files
Cancel
of
Date and Submission
Date Submitted
-
Month
-
Day
Year
Date
Submit
Should be Empty: