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P.A.W.S. Stray Animals Facebook Page
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Make a Lost Pet Flyer
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Contact Us
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When you adopt from a no-kill shelter, you save two lives. The animal you adopt and the one that replaces them.
New Volunteer Meeting
Saturday October 7 4:30 pm
P.A.W.S.
8301 W 191st Tinley Park, IL
UPCOMING EVENTS
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Canine Intake Form
Step
1
of
9
- Personal Information
11%
The following questionnaire provides us with information about how your dog behaved in many different circumstances while he or she was living with you. Because your dog is likely to behave in similar ways in his new home, this information will help us find the most suitable home for your dog and to effectively counsel the new family. Your open and honest answers are very necessary and appreciated, so that we can do careful and successful adoptions.
Person's Information
Name
*
First
Last
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Phone
*
Email
*
Animal's Information
Pet's Name
*
Species
*
---
Cat
Dog
Other
Age
*
If exact birthday is known please enter month, day and year otherwise your dogs age.
Sex
*
---
Male
Female
Altered
*
Yes
No
I do not know
Is your pet spayed or neutered.
Is your dog pure breed?
*
Yes
No
Breed
*
If your pet is not a pure breed please list what he/she is mixed with to the best of your ability.
Color
*
How long have you had this pet?
*
Is this animal up to date on Vaccinations?
*
Yes
No
Veterinary Information
Veterinary Name
Clinic Name
What is the reason for surrender?
*
Where did this pet come from?
*
Has this animal ever bitten someone?
*
Yes
No
Has this animal bitten or been bitten in the past 10 days? If so, please explain in detail:
*
Feeding History
What brand of dog food do you feed your dog?
*
How much food do you feed your dog?
*
How often do you feed your dog?
Example: 1 cup at 8am, 2 cups at 6pm, or only feed my dog in the morning.
Does your dog have any food allergies?
*
---
Yes
No
Please list what foods your pet is allergic to.
Medical History and Behavior towards the Veterinarian
Has your dog ever had surgery?
*
---
Yes
No
Please explain:
*
How does your dog behave during visits to the vet?
Is there anything else we should know about your dog’s medical history?
Household History
How did your dog usually interact with the following in your home?
Cats
Dogs
Children
Unfamiliar Adults
Does your dog do any of the following? (Check all that apply)
*
Jump on counters
Scratches doors/cabinets
Digs in garbage
Scratch furniture
Chews personal items
Barks too much
Chew Plants
Other
None of these
Please explain
*
How did you attempt to correct the problem(s)?
*
How would you describe this dog’s usual behavior? (Check all that apply)
*
Friendly to family
Friendly to visitors
Shy to family
Shy to visitors
More like a dog
Very active
Playful
Affectionate
Quiet
Fearful
A clown
Aloof
Talkative
Lap cat
Fearless
Couch Potato
Withdrawn
Independent
Solitary
When playing does your dog ever bite, scratch or exhibit behaviors you would consider rough?
*
---
Yes
No
Please explain:
*
Where does your dog like to sleep?
*
On furniture
Under furniture
In their bed
With a person
Anywhere sunny/warm
No preference
Other
If other, please explain
*
Are there any wonderful, special traits or habits that you would like his/her new family to know about?
Please upload a current photo of your pet.
Accepted file types: jpg, jpeg, png, gif.
Consent
I agree to the privacy policy.
CAPTCHA
P.A.W.S. Tinley Park
8301 W. 191st Street
Tinley Park, Illinois 60487
Telephone: (815) 464-7298
HOME
ABOUT US
Mission
Board of Directors
FAQ
ADOPT
Available Cats
Available Dogs
Policy & Applications
SURRENDER A PET
EVENTS
Events
GET INVOLVED
Ways to Donate
Membership
Volunteer
Junior Volunteer Program
Foster
Planned Giving
Wish List
PROGRAMS & SERVICES
Humane Education
Spay/Neuter
Pet Therapy
LOST PET RESOURCES
Stray Animals
P.A.W.S. Stray Animals Facebook Page
Lost Pet Tips
Make a Lost Pet Flyer
CONTACT US
Contact Us
Event/Fundraising Requests
DONATE