Intake Request Form - Small Animal and Exotics

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To provide the best service to our community and the best care possible for our shelter animals, HSCO schedules all owner surrendered intake. To request an appointment to surrender your pet, please complete the following form. Take your time and be detailed while completing this form as we will use this information to make thoughtful and compassionate future decisions regarding the ongoing care of your pet.

If you have more than one animal to surrender please indicate how many and as much description as possible about each animal in the provided space below. For behavior or medical questions please identify each animal in your responses if their behavior or medical history is different.

A HSCO representative will contact you within 1-2 business days to discuss your responses and set up an intake appointment once this form is submitted.

If it is an emergency, please complete this form and then call the shelter at 541-382-3537, extension 0.

If you have not done so already, please post your pet to Home To Home https://home-home.org/rehome

Owner Name (First and Last) *

Owner Address (Include City/Zip Code) *

Owner Phone Number (Please use dashes) *

Owner Email Address *

Describe the animal(s). Please be clear with number of animals requested and give individual descriptions of all. (Species/Breed/Age/Sex/Spayed/Neutered/Color/Name) *

What is the primary reason you are requesting intake for this animal(s)? *

Are there any services, resources, or otherwise, that if you had access to them, would allow you to keep your pet(s)? *

How did you obtain this animal(s)? *

How long have you owned this animal(s)? *

To the best of your knowledge, how many homes has this animal(s) had? *

Describe this animal's behavior or experience with other animals of it's kind. *

Describe this animal's behavior or experience with dogs and cats. *

Describe this animal's behavior or experience with children. *

Describe this animal's behavior or experience with strangers. *

Is this animal(s) litterbox trained? *

Please describe this animal's primary enclosure. Include details of size, set up, and location in your household. *

Are you able to surrender this animal(s) with their enclosure and supplies? *

Has this animal(s) ever shown aggression towards people or ever bitten anyone? Please provide details. *

Has this animal(s) bitten and broken skin on a person in the last 10 days? *

Has this animal(s) received any veterinary care while in your care or in the care of a previous owner? *

If yes, what is the name and location of the veterinary clinic and who's name would the records be listed under?

Has this animal received any vaccinations? If yes, please provide name of vaccine and date of administration. *

Does this animal have any known or suspected medical concerns? Please describe. *

What is this animal's current diet? Please describe and provide brand names/type if possible. *

Please include any other details or information about this animal(s) or intake request that you feel is important for HSCO to know.

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