Kalamazoo Animal Rescue

Dog and Puppy Intake Form

Please fill out this form as completely as you can if you have a dog or puppy that needs another home. Filling out this form allows us to review information about the animal.Please understand that completing this form does not mean your dog or puppy will be taken into one of our foster homes.

If we have space in one of our foster homes, a volunteer will respond to you by email or phone. Please be patient. We are all volunteers who donate our time and we have a limited number of foster homes.

Your Email Address:

Name:

Phone Number:

Street Address:

City:

State:

Zip Code:

County:

Is this your Animal or a Stray?
My Animal Stray Other

Age (in years or months):

Breed or Mix:

Male or Female
Male Female

Approximate Weight in Pounds:

Spayed or Neutered?
Yes No Don't Know

Up to Date on Shots?
Yes No Don't Know

Has it had a Heartworm Check within the Past Year?
Yes No Don't Know

Up to Date on Heartworm Preventative?
Yes No Don't Know

Good with Children?
Yes No Don't Know

Good with Other Dogs?
Yes No Don't Know

Good with Cats?
Yes No Don't Know

Other Behaviors of the Animal:

Reasons for Relinquishing the Animal:

Has this Animal ever Bitten Anyone?
Yes No Don't Know

Upload a Picture: MUST BE UNDER 2MB



Any Additional Comments:

By checking this box, you affirm that all of the above information is complete and correct


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  Kalamazoo Animal Rescue
  P.O. Box 3295
  Kalamazoo, MI 49003

  269.226.8570
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