Intake Appointment Request
By submitting this request form, I understand that this shelter has the right to accept or deny my surrender application. Intake staff will be in touch if SSHS is able to accept your pet. THIS APPLICATION DOES NOT MEAN WILL TAKE YOUR PET, PLEASE DO NOT BRING IT TO THE SHELTER UNLESS AN APPOINTMENT DATE/TIME HAS BEEN SET. PLESE EXPECT 48 HOURS FOR A RESPONSE.
Email address *
First Name *
Last Name *
Street Address *
City *
State *
Primary Phone Number *
Intake Type *
Type of Pet *
Breed *
Age *
Is the pet spay/neutered?
Clear selection
How long have you had this pet? *
Does the pet have a bite record? Meaning has the pet bitten someone or another animal in the past *
If you answered yes to the above question, did the bite occur within the last 10 days?
Clear selection
What's the reason for surrender? (We have resources available to help you keep your pet!) *
Anything else you'd like to share
Submit
Never submit passwords through Google Forms.
This form was created inside of South Suburban Humane Society. Report Abuse