Stray Animal

Contact Information

Name(Required)

First Last

Phone(Required)

Email(Required)

Enter Email Confirm Email

Address(Required)

Street Address Address Line 2 City State ZIP Code

Animal Information

Please upload a photo of the animal(Required)

Accepted file types: jpeg, jpg, png, pdf, heic, Max. file size: 300 MB.

Sex of animal(Required)

Male

Female

Unknown

Animal Type(Required)

Please choose the animal type.

Dog

Cat

Other

Other Animal Type(Required)

Please list the species and breed type

Animal Breed Type(Required)

Please make your best guess as to the breed type of the animal. For cats, you can use DSH (Domestic Shorthair) or DLH (Domestic Longhair)

Animal Coat Color(Required)

Animal Temperament(Required)

Friendly and tame

Scared but seems generally friendly

I cannot touch this animal

Other

Animal Health(Required)

Please choose all that apply.

Seems healthy and uninjured

Has a visible illness / concerned about illness

Has a visible injury / concerned about a possible injury

Injury Type(Required)

What kind of injury are you seeing? Choose all that apply.

Open Wound

Abscess

Broken Bone

Not Walking/Moving

Hit by Car

Missing Limb/Tail

Foot Injury

Bleeding

Other

Illness Type(Required)

What kind of symptoms are you seeing? Choose all that apply.

Runny/Watery/Goopy Eyes

Eyes Crusted Shut

Nasal Discharge/ Runny Nose

Lethargic

Wheezing

Coughing

Ear Discharge/Discomfort

Diarrhea

Vomiting

Frothing at the Mouth

Underweight

Other

Other Illness(Required)

Please describe

Other Injury(Required)

Please describe

How long have you been caring for this animal?(Required)

For example, you can enter '1 day,' '2 weeks,' or '4 months.

Location when Found(Required)

Could you please provide details about where this animal was discovered? We're looking for the street names and the city to help in reuniting the animal with its owner.

Efforts to Find Owner(Required)

Have you looked for an owner in your area? What steps have you done to try to locate an owner?

Notify me for Adoption(Required)

Would you like to be notified if this animal is not claimed so that you may adopt him/her? *By checking this box, you are signing up for the Finder's First Program. We will notify you if the animal is placed for adoption. You will have option for the first appointment if you meet adoption criteria and qualifications. We will send you an application that must be filled out in order to be notified.

Yes

Are you aware if this animal ever bitten a human or other animal?(Required)

Yes

Biting Information

Has this animal bitten a person or another animal in the last 10 days?(Required)

Yes

Did the bite break skin?(Required)

Yes

Was medical attention required?(Required)

Yes

What medical attention was needed?(Required)

Basic first aid, tetanus shot

Stitches/Sutures

Surgery

Other

Please describe the medical attention(Required)

Was there a trigger that led up to the bite?(Required)

Resource guarding (food, toy, person, etc.)

Uncomfortable social interaction (hug, climbed on, physical correction, etc.)

Redirected bite (lunging at another animal or person and redirected to the closest human or animal instead)

Unknown

Other

Other Trigger(Required)

Please describe what you believe triggered the bite reaction

Please describe the bite incident(Required)

Other Animal Intake Information

Animal age(Required)

What is the approximate age of this animal?

Young / baby

Adult

Senior / older

Cat Intake Information

Cat Stray Type(Required)

Single cat

Multiple cats but not kittens

Litter of kittens

Number of cats/kittens(Required)

Please list the number of cats and/or kittens

Please enter a number from 1 to 100.

Domesticated or Feral(Required)

Please choose the option that you think best describes the cat

Domesticated

Feral

Current Living Situation(Required)

Cat is still outside

I brought the cat inside

I have been caring for this cat for more than one week

Duration in Area(Required)

How long has this cat been in the area? (Ex: 1 day, 2 weeks etc.)

Duration of Care(Required)

How long have you been caring for this cat?

Dog Intake Information

Dog Stray Type(Required)

Single Dog

Puppies

Dog with Puppies

Other

Number of Puppies(Required)

How many puppies are in the litter?

Please enter a number from 1 to 20.

Collar(Required)

Is the animal wearing a collar?

Yes

Additional Information

Is there any additional information you would like to provide?(Required)

Yes

Additional Information(Required)

Terms and Conditions

Consent(Required)

I have read and agree to all of the following:

1. I certify that I am 18+ years old.

2. I understand that intake staff is not available on evenings or Sundays.

3. I certify that this is not my personal pet.

4. I understand that my information will NOT be given to the owner of the animal when they retrieve their pet from the shelter.

5. I understand that I can opt in or out of the Finder's First Program.

I Agree to the Terms and Conditions Above.

Please upload a photo of your Drivers License or Government issued ID(Required)

Accepted file types: jpeg, jpg, png, pdf, heic, Max. file size: 300 MB.

Signature(Required)

By signing above you are indicating that all information you have provided is truthful and accurate. By submitting the following form you are acting in good faith and giving the described animal irrevocably to the West Valley Humane Society for whatever disposition the shelter deems best. Due to privacy concerns or complications with the disposition of any animal WVHS may not be able to provide additional information to the general public on a specific animal. Please note, if we find that the owner of an animal has dishonestly completed this form, there may be criminal charges for animal abandonment and falsification of documents.

Contact Information

Animal Information

Biting Information

Other Animal Intake Information

Cat Intake Information

Dog Intake Information

Additional Information

Terms and Conditions

Contact Us

Hours (Appointment Only)

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