Intake Request

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1About you

2About the animal

3Acknowledgements

Your Name *

First

Last

Are you over 18? *

HAVA is only able to accept surrendered animal from adults 18 and over. Please have a parent or guardian complete this request!

Email *

Phone *

Mailing Address *

Address Line 1

City

State

Zip Code

Different Physical Address

My Mailing address and physical address are the same.

Physical Address *

Address Line 1

City

State

Zip Code

Type/Species *

Cat
Dog
Other

HAVA is a cat shelter and unable to take Dog surrenders!

We recommend posting your dog on Home to Home: https://home-home.org/register/?step=1

To the best of your knowledge, select the option that best fits the situation: *

This is my cat.
I don’t own this cat, but I know who does
I don’t know who owns this cat. It's friendly though!
I don’t know who owns this cat. It's wild / feral.

To the best of your knowledge, select the option that best fits the situation: *

This is my dog
I don’t own this dog, but I know who does
This is a lost and found dog

Who is the owner? *

Please provide the owner's name and any contact information you may have.

Why do you believe this animal is a stray or feral? *

The best way to get an owned cat back home is often just to leave it where it is so the owner can find it; the cat likely belongs to one of your neighbors. If the animal has an ear tip (an ear with its tip cut off diagonally), this may indicate that the cat is feral but has been previously trapped and spayed or neutered. At some point, it was determined that this cat was not suitable for adoption, and you should not try to pick it up or handle it as it is most likely more wild than tame. (NOTE: Occasionally, tame cats do end up with ear tips.)

Pet's name *

Breed

Gender *

Female
Male
Unknown

Please provide a physical description of the animal:

Provide the pet's date of birth if known

If you don't have a date of birth, please provide an estimated age

Is this animal spayed or neutered? *

Yes
No
Unknown

Microchipped?

This animal is microchipped

Please provide microchip number if known

Is this animal current on vaccinations? *

Yes
No
Unknown

Last Vet Visit (if known)

Veterinary Information (Name & Phone if possible)

Does this animal have special needs or behavioral issues? *

Yes
No
Unknown

Please provide additional details *

History *

If possible, please write a full bio on the animal below. This should include information about the animal's personality, traits, habits, likes, dislikes, and history. The more information we have, the better we'll be able to find a home for the animal!

How long have you been caring for this animal? *

Please provide the reason you are surrendering this animal *

Upload a picture or two (if available)

Click or drag files to this area to upload. You can upload up to 3 files.

Anything else you think we should know that wasn't covered above?

I agree to the following:

I certify that the above information I have given is accurate and truthful, and I authorize a HAVA member to verify all information in this request.
I certify that either I am the owner or, to the best of my knowledge, no other person has any right to this animal.
I hereby surrender all rights to this animal.
I understand that once I relinquish the animal, the animal will not be available to be returned.

By submitting this form electronically, you understand the terms of this request.