Los Angeles Fire Evacuation Animal Services Assistance Request

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

NOTA: Para español, haga clic aquí

If you are a person with a disability and need help retrieving your pet from an evacuation area as a result of the wildfires, please fill out the form below.

Your request will be reviewed by a care team composed of LA Animal Services staff and LAPD officers, who will take appropriate action to locate and rescue your pet. You will be notified once the care team has visited the property.

If you are unable to complete this form independently, a representative may fill it out on your behalf. If you need additional assistance completing this form, please contact emd.dafn@lacity.org, call 311, or dial 711 for CA Relay for support.

Email *

Name *

Email Address *

Phone Number

Last Known Address of Your Pet *

Description of Your Pet

Include your pet’s species, breed, color, and any other identifying features.

Your Pet’s Special Needs or Requirements

Let us know about any special needs your pet has (ex: medication, mobility issues, or unique behaviors).

Preferred Contact Method

Phone Call

Text Message

Other:

Required

Communication Accommodations

Large Print

Braille

Email-only communication

Live ASL Interpreter

Other:

Required

Authorized Representative Contact

Do you have an authorized representative who can assist on your behalf? If yes, please provide their contact information in the next question below.

Yes, I have an authorized representative.

No, I will handle this myself.

Clear selection

If you answered yes above, please provide your Authorized Representative's:

Full Name, email address, and phone number

Entry Details for Rescue

Provide any details to help rescuers identify or access the location.

Accessing Your Home

Include any access instructions, ex: gate codes, specific directions, or unique features.

By checking this box, I attest that I have reviewed and confirmed the information provided in this form is accurate to the best of my knowledge.

I attest that I have reviewed and confirmed the information provided in this form is accurate to the best of my knowledge.

Required

Send me a copy of my responses.

Submit

Clear form

Never submit passwords through Google Forms.

reCAPTCHA

Privacy Terms

This form was created inside of City of Los Angeles.

Does this form look suspicious? Report

Forms