Intake Request – together-furever.org

Owner Information

We need a little information about you to help us better fit your needs. Please complete the form to the best of your ability. The more information we have, the better we can help you and your pet.

Today's Date

Name *

First

Last

Email *

Phone *

Best contact number to reach you in case of emergency

Mailing Address

Address Line 1

City

State

Zip Code

Current Living Accomodations *

Unhoused (Street, Car, Park etc)
Emergency Shelter
Transitional Housing
Other

If you chose other please explain

Pet Information

Now we need a little information about your pet. Please be as honest as you can about your pet. This will help us place your pet in the appropriate foster/boarding facility.

Name of Pet #1 *

Type of Pet *

Sex of pet *

Male
Female

Pet Age

Breed/Color/Markings on pet *

Has your pet been spayed/neutered? *

Yes
No

Name of Pet #2

Type of Pet

Sex of pet

Male
Female

Pet Age

Breed/Color/Markings on pet:

Does your pet(s) have any illness or health issues we should know about? *

If so, please explain

Do any of the following apply to your pet(s)?

Allergies
Dietary Restrictions
Requires Medication

Behavior/Temperament of your pet(s) *

Are there any restrictions or behaviors we should be aware of? For instance, resource or food gaurding. Maybe your pet doesn’t do well with small children or other pets. These are things we need to know to place your pet in the appropriate foster environment.

Estimated length of boarding *

Please explain how long you will need to board your pet.

Veterinarian Clinic Name *

If you do not have a vet, please put “none” in the field. We use this to verify shot records in the event we need to board your pet with other pets in the home.

Veterinarian Address

Address Line 1

City

State

Zip Code

If you don’t know the exact address please put the cross streets of its location. (ie.. 72nd & Dodge St.)

Current Vaccinations of your pet(s), please check all that apply: *

If you are unsure please make sure your vet information is up to date so we can verify vaccinations.

Terms & Conditions *

I certify this I am the legal owner of the pet(s) mentioned above

Signature *

By inputting your name above, you agree the form is filled out to the best of your knowledge. Any false information given will void any arrangements made between you and Together Furever.

Date *