Intake Request Form
If you are contacting us to surrender an animal, please fill out the Intake Request Form below. One form per animal is required.
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Email *
Today's Date *
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Your First Name *
Your Last Name *
Phone Number *
COMPLETE Address (street, city, state, zip) *
Animal Name *
Species *
Breed *
Sex *
Age *
Approximate Weight (lbs.) *
Is the animal house trained, crate trained or little box trained? *
Please tell us about the animal. (For example, likes/dislikes, good or not good with dogs/cats/livestock/small animals/children.) *
Is the animal up to date on vaccinations? *
When was the last time the animal received heartworm/flea/tick prevention? What was the name of the product? *
Where did you acquire the animal from initially? If a rescue/shelter, please provide name. *
How long have you owned the animal? *
Why are you planning to rehome your animal? *
What is your timeframe for rehoming? *
I understand to have my animal(s) considered, I must send a follow-up email to this form to info@vocalforpets.org with pictures and medical records of my animal(s) and MY ANIMAL'S NAME and MY LAST NAME in the subject line. * *
I understand that submitting this form does not mean that VOCAL can take my animal(s). *
Required
I understand that submission of this form does not guarantee a response. VOCAL receives a large volume of requests and only responds to the ones they are able to help. *
Required
A copy of your responses will be emailed to the address you provided.
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This form was created inside of VOCAL (Voices of Change Animal League).

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