Portland – Small Pet Intake - Oregon Humane Society

Your Name*

First Last

Phone Number*

Email*

Address

Street Address Address Line 2 City State ZIP Code

Please choose why you are filling out this form.*

I have a small pet I am fostering.
I have a small pet I am surrendering.

What is your foster pet's ID number?*

Pet's Type*

Pet's Name*

Age*

Pet's Gender*

Male
Female

Is the pet spayed/neutered?*

Yes
No

How long have you fostered this pet?*

How long have you owned this pet?*

Where did you acquire this pet?*

Has this pet ever bitten?*

Yes
No

If yes, what were the circumstances?*

Why do you need to rehome this pet?*

Are there any places on this pet's body that it does not like to be touched?*

Yes
No

If yes, please explain where on the body and what they do when touched in that area.*

Can you pick up and hold this pet?*

Yes
No

If no, what happens when you try?*

How long can you hold this pet?*

Where was this pet mainly kept?*

Indoors
Outdoors

Describe this pet's housing (cage, hutch, etc.):*

Is this animal litter box trained?*

Yes
No

What is your pet's current diet? (Check all that apply)*

When do you feed? (Check all that apply)*

AM
PM
Free feed

Does this pet prefer their water from:*

Water bottle
Floor bowl

This animal is compatible with (check all that apply):*

If other, who is this pet also compatible with?*

How would you describe this pet? (Check all that apply)*

What are this pet's favorite toys?*

What does this pet like to chew on?*

Does this pet have any known illnesses or conditions?*

Yes
No

If yes, please explain:*

Has this pet seen a vet in the last year?*

Yes
No

If yes, what vet office did you go to?*

How did your pet react at the vet?*

Is there anything else you would like us to know about this pet?

Small Pet Personality