Humane Colorado - Pet Assist Form

Case Status:*
Case Type:*
Workflow ID*
Assigned To*
Pet Assist Inquiry

The Pet Assist program helps those in need of a temporary safe place for their pet to live due to a variety of factors that leave them unable to care for their animals and when no other assistance is available. Pet assist is a short-term, foster-based program. The more information you can provide on your application can help fund this program for future families and pets, and help you find a placement for your pet.
Tell Us About Yourself

Please give us some information about you and why you need Pet Assist.
Name*

First NameLast Name
Phone Number*
Please enter a valid phone number.
Email Address*
If you do not have an email address, please use none@none.com
Address*

Street Address

Street Address Line 2

CityState

Zip Code
Zip Code*
What is your preferred method of contact?*

EmailPhoneText
What is the reason you are seeking help?*
What other options have you looked into/tried? *
What is your plan to reunify with your pet while they are in care? Do you need any resources to help you achieve your goals?*
When do you need help? *

MonthDayYear
Date
How long do you need help?*
Did you adopt your pet(s) from DFL?*

YesNo
Have you adopted from us before?*

YesNo
Are your pets currently or have they recently been a part of a temporary care program?*

YesNo
What is the name of the program?*
How many pets need temporary care? *
Please input a number between 1-5. If you have more than 5 animals you will need to fill out another form to add them.

Tell Us About Your Pets

You will be able to fill out information for up to 5 individual animals.
Animal Type*

DogCatOther
You select "Other", please specify.
Pet Name*
Dog Breed*
Cat Breed*
Age*
Weight*
Gender*
**You have either selected that your pet is not spayed/neutered or "Unknown". If accepted into Pet Assist, it is a requirement that they are spayed/neutered, and this cannot be waived. We can spay/neuter them free of cost to you.**
Briefly describe their personality and how they behave around you:*
Is your cat litter box trained?*

YesNo
Litter Trained
Is your dog house-trained?*

YesNo
House Trained
Does your dog exhibit resource guarding towards humans or other dogs? (ie. toys, treats, food bowls, human food, etc.)*

Yes my dog exhibits resource guardingNo my dog does not exhibit resource guarding
Please explain your pet's resource guarding behavior. *
Please describe your pet’s diet and feeding routine. *
Please describe your pet’s bathroom habits and routine. *
What toys or enrichment does your pet prefer? *
What sleeping arrangements does your pet prefer? *
What commands does your pet know? *
How are they on leash? *
Is your pet microchipped? (If accepted into Pet Assist and they are not, they will be microchipped free of cost to you.)*

YesNoNot sure
Medical Event
Does your pet get along with dogs?*

YesNoNot sure
Please explain your pet's behavior around dogs. *
Does your pet get along with cats?*

YesNoNot sure
Please explain your pet's behavior around cats. *
Does your pet get along with kids?*

YesNoNot sure
Please explain your pet's behavior around kids. *
How does your pet behave around strangers/in new places?*
Where does your pet stay in your house?
Where does your pet stay when they are alone and how do they do alone?
Is your pet crate-trained?*

Yes my pet is crate trainedNo my pet is not crate trained
Are they destructive?*

Yes my pet is destructiveNo my pet is not destructive
Tell us more about how your pet is destructive.*
Does your pet swallow any items that are not food?*

Yes my pet ingests items that are not foodNo my pet does not ingest items that are not food
What items does your pet ingest?*
Have they ever had surgery to remove a non-food item? *

YesNo
Please explain the surgery and what non-food items were removed.*
Has your pet ever escaped? *
When was the last time your pet went to the vet?*
Does your pet have any medical conditions or take any medications/supplements?*

YesNo
Please share details about your pet's medical concerns/conditions.
Does your pet have any behavioral concerns/information?*

YesNo
Please share details about your pet's behavioral concerns/information.
Has your pet ever bitten anyone (humans or other animals)?*

YesNo
Please explain what happened before, during, and after the bite. How did your pet communicate they might have been uncomfortable?*
Bite History Tag
Add a photo of your pet

Max. file size: 64 MB. Please upload a picture of your pet showing their face and body. Please do not submit photos of animals with people or other pets in them, if possible. Uploading a clear picture helps us help you faster!
Cancelof
Upload any documents you have for your pet

Vet documents, vaccines, behavior assessments, CVI, etc.
Cancelof
Animal Privacy Setting
Do you have a second pet?*

YesNo
Second Animal Type

DogCatOther
You select "Other", please specify.
Second Pet's Name
Dog Breed*
Cat Breed*
Age
Weight
Gender
**You have either selected that your pet is not spayed/neutered or "Unknown". If accepted into Pet Assist, it is a requirement that they are spayed/neutered, and this cannot be waived. We can spay/neuter them free of cost to you.**
Briefly describe their personality and how they behave around you:*
Is your cat litter box trained?

YesNo
Litter Trained
Is your dog house trained?

YesNo
House Trained
Does your dog exhibit resource guarding towards humans or other dogs? (ie. toys, treats, food bowls, human food, etc.)*

Yes my dog exhibits resource guardingNo my dog does not exhibit resource guarding
Please explain your pet's resource guarding behavior. *
Please describe your pet’s diet and feeding routine. *
Please describe your pet’s bathroom habits and routine. *
What toys or enrichment does your pet prefer? *
What sleeping arrangements does your pet prefer? *
What commands does your pet know? *
How are they on leash? *
Is your pet microchipped? (If accepted into Pet Assist and they are not, they will be microchipped free of cost to you.)

YesNoNot sure
Medical Event
Does your pet get along with dogs?

YesNoNot sure
Please explain your pet's behavior around dogs. *
Does your pet get along with cats?

YesNoNot sure
Please explain your pet's behavior around cats. *
Does your pet get along with kids?

YesNoNot sure
Please explain your pet's behavior around kids. *
How does your pet behave around strangers/in new places?
Where does your pet stay in your house?
Where does your pet stay when they are alone and how do they do alone?
Is your pet crate-trained?*

Yes my pet is crate trainedNo my pet is not crate trained
Are they destructive?*

Yes my pet is destructiveNo my pet is not destructive
Tell us more about how your pet is destructive.*
Does your pet swallow any items that are not food?*

Yes my pet ingests items that are not foodNo my pet does not ingest items that are not food
What items does your pet ingest?*
Have they ever had surgery to remove a non-food item? *

YesNo
Please explain the surgery and what non-food items were removed.*
Has your pet ever escaped?*
When was the last time your pet went to the vet?
Does your pet have any medical conditions or take any medications/supplements?

YesNo
Please share details about your pet's medical concerns/conditions.
Does your pet have any behavioral concerns/information?

YesNo
Please share details about your pet's behavioral concerns/information.
Has your pet ever bitten anyone (humans or other animals)?*

YesNo
Please explain what happened before, during, and after the bite. How did your pet communicate they might have been uncomfortable?*
Bite History Tag
Add a photo of your pet

Max. file size: 64 MB. Please upload a picture of your pet showing their face and body. Please do not submit photos of animals with people or other pets in them, if possible. Uploading a clear picture helps us help you faster!
Cancelof
Upload any documents you have for your pet

Vet documents, vaccines, behavior assessments, CVI, etc.
Cancelof
Animal Privacy Setting
Do you have a third pet?*

YesNo
Third Animal Type*

DogCatOther
You select "Other", please specify.
Third Pet's Name
Dog Breed*
Cat Breed*
Age
Weight
Gender
**You have either selected that your pet is not spayed/neutered or "Unknown". If accepted into Pet Assist, it is a requirement that they are spayed/neutered, and this cannot be waived. We can spay/neuter them free of cost to you.**
Briefly describe their personality and how they behave around you:*
Is your cat litter box trained?

YesNo
Litter Trained
Is your dog house trained?

YesNo
House Trained
Does your dog exhibit resource guarding towards humans or other dogs? (ie. toys, treats, food bowls, human food, etc.)*

Yes my dog exhibits resource guardingNo my dog does not exhibit resource guarding
Please explain your pet's resource guarding behavior. *
Please describe your pet’s diet and feeding routine. *
Please describe your pet’s bathroom habits and routine. *
What toys or enrichment does your pet prefer? *
What sleeping arrangements does your pet prefer? *
What commands does your pet know? *
How are they on leash? *
Is your pet microchipped? (If accepted into Pet Assist and they are not, they will be microchipped free of cost to you.)

YesNoNot sure
Medical Event
Does your pet get along with dogs?

YesNoNot sure
Please explain your pet's behavior around dogs. *
Does your pet get along with cats?

YesNoNot sure
Please explain your pet's behavior around cats. *
Does your pet get along with kids?

YesNoNot sure
Please explain your pet's behavior around kids. *
How does your pet behave around strangers/in new places?
Where does your pet stay in your house?
Where does your pet stay when they are alone and how do they do alone?
Is your pet crate-trained?*

Yes my pet is crate trainedNo my pet is not crate trained
Are they destructive?*

Yes my pet is destructiveNo my pet is not destructive
Tell us more about how your pet is destructive.*
Does your pet swallow any items that are not food?*

Yes my pet ingests items that are not foodNo my pet does not ingest items that are not food
What items does your pet ingest?*
Have they ever had surgery to remove a non-food item? *

YesNo
Please explain the surgery and what non-food items were removed.*
Has your pet ever escaped?*
When was the last time your pet went to the vet?
Does your pet have any medical conditions or take any medications/supplements?

YesNo
Please share details about your pet's medical concerns/conditions.
Does your pet have any behavioral concerns/information?

YesNo
Please share details about your pet's behavioral concerns/information.
Add a photo of your pet

Max. file size: 64 MB. Please upload a picture of your pet showing their face and body. Please do not submit photos of animals with people or other pets in them, if possible. Uploading a clear picture helps us help you faster!
Cancelof
Upload any documents you have for your pet

Vet documents, vaccines, behavior assessments, CVI, etc.
Cancelof
Animal Privacy Setting
Do you have a fourth pet?*

YesNo
Fourth Animal Type

DogCatOther
You select "Other", please specify.
Fourth Pet's Name
Dog Breed*
Cat Breed*
Age
Weight
Gender
**You have either selected that your pet is not spayed/neutered or "Unknown". If accepted into Pet Assist, it is a requirement that they are spayed/neutered, and this cannot be waived. We can spay/neuter them free of cost to you.**
Briefly describe their personality and how they behave around you:*
Is your cat litter box trained?

YesNo
Litter Trained
Is your dog house trained?

YesNo
House Trained
Does your dog exhibit resource guarding towards humans or other dogs? (ie. toys, treats, food bowls, human food, etc.)*

Yes my dog exhibits resource guardingNo my dog does not exhibit resource guarding
Please explain your pet's resource guarding behavior. *
Please describe your pet’s diet and feeding routine. *
Please describe your pet’s bathroom habits and routine. *
What toys or enrichment does your pet prefer? *
What sleeping arrangements does your pet prefer? *
What commands does your pet know? *
How are they on leash? *
Is your pet microchipped? (If accepted into Pet Assist and they are not, they will be microchipped free of cost to you.)

YesNoNot sure
Medical Event
Does your pet get along with dogs?

YesNoNot sure
Please explain your pet's behavior around dogs. *
Does your pet get along with cats?

YesNoNot sure
Please explain your pet's behavior around cats. *
Does your pet get along with kids?

YesNoNot sure
Please explain your pet's behavior around kids. *
How does your pet behave around strangers/in new places?
Where does your pet stay in your house?
Where does your pet stay when they are alone and how do they do alone?
Is your pet crate-trained?*

Yes my pet is crate trainedNo my pet is not crate trained
Are they destructive?*

Yes my pet is destructiveNo my pet is not destructive
Tell us more about how your pet is destructive.*
Does your pet swallow any items that are not food?*

Yes my pet ingests items that are not foodNo my pet does not ingest items that are not food
What items does your pet ingest?*
Have they ever had surgery to remove a non-food item? *

YesNo
Please explain the surgery and what non-food items were removed.*
Has your pet ever escaped?*
When was the last time your pet went to the vet?
Does your pet have any medical conditions or take any medications/supplements?

YesNo
Please share details about your pet's medical concerns/conditions.
Does your pet have any behavioral concerns/information?

YesNo
Please share details about your pet's behavioral concerns/information.
Add a photo of your pet

Max. file size: 64 MB. Please upload a picture of your pet showing their face and body. Please do not submit photos of animals with people or other pets in them, if possible. Uploading a clear picture helps us help you faster!
Cancelof
Upload any documents you have for your pet

Vet documents, vaccines, behavior assessments, CVI, etc.
Cancelof
Animal Privacy Setting
Do you have a fifth pet?*

YesNo
Fifth Animal Type

DogCatOther
You select "Other", please specify.
Fifth Pet's Name
Dog Breed*
Cat Breed*
Age
Weight
Gender
**You have either selected that your pet is not spayed/neutered or "Unknown". If accepted into Pet Assist, it is a requirement that they are spayed/neutered, and this cannot be waived. We can spay/neuter them free of cost to you.**
Briefly describe their personality and how they behave around you:*
Is your cat litter box trained?

YesNo
Litter Trained
Is your dog house trained?

YesNo
House Trained
Does your dog exhibit resource guarding towards humans or other dogs? (ie. toys, treats, food bowls, human food, etc.)*

Yes my dog exhibits resource guardingNo my dog does not exhibit resource guarding
Please explain your pet's resource guarding behavior. *
Please describe your pet’s diet and feeding routine. *
Please describe your pet’s bathroom habits and routine. *
What toys or enrichment does your pet prefer? *
What sleeping arrangements does your pet prefer? *
What commands does your pet know? *
How are they on leash? *
Is your pet microchipped? (If accepted into Pet Assist and they are not, they will be microchipped free of cost to you.)

YesNoNot sure
Medical Event
Does your pet get along with dogs?

YesNoNot sure
Please explain your pet's behavior around dogs. *
Does your pet get along with cats?

YesNoNot sure
Please explain your pet's behavior around cats. *
Does your pet get along with kids?

YesNoNot sure
Please explain your pet's behavior around kids. *
How does your pet behave around strangers/in new places?
Where does your pet stay in your house?
Where does your pet stay when they are alone and how do they do alone?
Is your pet crate-trained?*

Yes my pet is crate trainedNo my pet is not crate trained
Are they destructive?*

Yes my pet is destructiveNo my pet is not destructive
Tell us more about how your pet is destructive.*
Does your pet swallow any items that are not food?*

Yes my pet ingests items that are not foodNo my pet does not ingest items that are not food
What items does your pet ingest?*
Have they ever had surgery to remove a non-food item? *

YesNo
Please explain the surgery and what non-food items were removed.*
Has your pet ever escaped?*
When was the last time your pet went to the vet?
Does your pet have any medical conditions or take any medications/supplements?

YesNo
Please share details about your pet's medical concerns/conditions.
Does your pet have any behavioral concerns/information?

YesNo
Please share details about your pet's behavioral concerns/information.
Add a photo of your pet

Max. file size: 64 MB. Please upload a picture of your pet showing their face and body. Please do not submit photos of animals with people or other pets in them, if possible. Uploading a clear picture helps us help you faster!
Cancelof
Upload any documents you have for your pet

Vet documents, vaccines, behavior assessments, CVI, etc.
Cancelof
Animal Privacy Setting

Final Information
Please provide additional details on how we can assist you.*
Where did you hear about Pet Assist at Humane Colorado?*

Family/FriendWebsiteSocial MediaVeterinarian ReferralOther
Please verify that you are human*
Should be Empty:

Tell Us About Yourself

Tell Us About Your Pets

Final Information