Stanislaus Pet Resource Center Questionnaire
The goal of the Stanislaus Pet Resource Center is to help local pet owners help keep their pets in their homes by working collaboratively with owners to find alternatives to surrender to shelters. Resources may include but are not limited to: financial or medical assistance, pet food and supplies, assistance with pet deposit or impound fees, and home repairs/upgrades to keep pets safely contained. Our ability to accept pet families into the program is based on a combination of factors and currently available resources.
Please complete the following form to apply for assistance.
* Required
Name
*
Your answer
Street Address
*
Your answer
City, State, Zip
*
Your answer
Phone Number
*
Your answer
Email
Your answer
Are you an active member or veteran of the United States armed forces?
Yes
Where did you hear about the Resource Center
*
Government Agency/Outreach
Non-Profit Organization
Veterinarian
Stanislaus County Animal Services
Oakdale Animal Services
Turlock Animal Services
Newman Animal Services
Other
Required
What programs or services would help you keep your pet? Select all that apply.
Assistance paying a pet deposit or pet rent
Free or low-cost vaccines
Free or low-cost veterinary care
Free or low-cost pet food/supplies
Free or low-cost spay/neuter surgery
Free or low-cost temporary boarding or pet care
Free or low-cost training to help with behavior problems
Assistance paying licensing or impound fees
Free or low-cost humane euthanasia
Free or low-cost grooming
No services needed
Pet's name?
Your answer
What is the breed or breed mix?
Your answer
How long have you had your pet?
Your answer
Species
Dog
Cat
Other
How old is it (best guess)?
Your answer
Gender
Female
Female Spayed
Male
Male Neutered
Unsure if Spayed/Neutered
Is your pet microchipped
Yes
No
Unsure
Has your pet received any vaccinations with the past year?
Yes
No
Unsure
If yes, do you have the current vaccination records?
Yes
No
Unsure
Are you requesting euthanasia?
Yes
No
Considering
Click submit and you will see a message that your form has been submitted.
Submit
Page 1 of 1
Never submit passwords through Google Forms.
Forms
This content is neither created nor endorsed by Google.
Terms of Service