BASIC ANIMAL INFORMATION

What is the animal's sex?
Is the animal spayed or neutered?
Is the animal declawed?
Is the animal sick or injured?
Does the animal have any ongoing medical issues?
Is it okay to contact you for further information?
     
 

ANIMAL’S BITE HISTORY

We request information on any type of bite that may have taken place to ensure the safety of both the animal and those who will care for it.  A bite history does not mean an animal will be euthanized. We will look at a variety of things, such as the circumstances, severity, and timing of the bite, in order to make a decision.

Has your animal ever bitten (and broken skin)?
Has this animal bitten within the last 10 days?
     
 

ANIMAL’S TEMPERAMENT & TRAINING

Although we evaluate every dog and cat to ensure they are appropriate for adoption, we also rely on owners to provide information regarding the behavior of the animal. We believe the information gathered from an animal’s previous home can help us match the animal with a new family.

This section asks for details about the animal and the people and pets it has lived with. Please provide information based on animals and people the animal has lived with or interacted with on a regular basis. 

This animal has lived with:
     
 

For the next section please describe what type of housetraining your animal has mastered or please note if it has issues with this.


By signing below I understand:   1) when I surrender my animal to the shelter, I am relinquishing ownership to Women's Animal Center;  2) Women's Animal Center will work toward finding a live exit for this animal but it is not guaranteed; 3) This animal will be assessed for risk of suffering and/or harm to itself and others; 4)  following an assessment Women's Animal Center may place this animal through adoption, foster care, transfer to another animal rescue organization, or this animal may be euthanized, and I understand that I will not receive communication prior to any of those decisions being made.

I acknowledge by signing below I have relinquished all rights and decision making regarding this animal to Women's Animal Center.

I certify that the information provided about this animal is true and correct.