Request for Service

If you or someone you know is in crisis, escaping violence, or otherwise needs a temporary safe place for animals to go while individuals get the help they need, please fill out the Request for Service for below and we will review your needs and get in touch with you as soon as possible. If you prefer a PDF form, please contact Cassie, No Pet Left Behind Coordinator, at [email protected] or 604-506-9297.

Depending on the number and type of pets that you would like to foster, we also ask that you complete our Canine Supplementary Information Form and/or our Feline Supplementary Information Form to help us find the most appropriate and foster home for your animal(s).

• Canine Supplementary Information Form
• Feline Supplementary Information Form

Crisis Foster Care Request for Service Form

CONTACT INFORMATION

Name *

First

Last

Address *

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Home Phone *

Cell Phone *

Work Phone

Email *

Email

Confirm Email

How many pets need to be fostered? *

• 1
• 2
• 3

Anticipated Intake Date: When do you want us to take in your pet? *

• As soon as possible
• A specific date
• Unknown/TBD

What date?

PET INFORMATION

Pet 1: Name *

Pet 1: Species *DogCatSmall animalBirdReptileOther

Pet 1: Age or Date of Birth *

Pet 2: Name

Pet 2: SpeciesDogCatSmall animalBirdReptileOther

Pet 2: Age or Date of Birth

Pet 3: Name

Pet 3: SpeciesDogCatSmall animalBirdReptileOther

Pet 3: Age or Date of Birth

Veterinarian/Clinic Name *

Veterinarian Phone

Veterinarian Email

Is your pet(s) spayed/neutered? *

• Yes
• No

Do you agree to allow Paws for Hope to have your pet(s) spayed/neutered?

• Yes
• No

Paws for Hope will pay the cost for this service.

Is your pet(s) tattooed or micro-chipped for identification?

• Yes
• No

Tattoo/Microchip Identification Number

Please provide details...

How did you hear about Paws for Hope?

• Internet search
• Family/friend referral
• Police
• Social worker
• Nurse
• Other support worker
• Veterinarian
• Social Media
• Other

CARE INFORMATION

Please provide any information to ensure we can provide the best care possible for your pet(s). *

For example, special needs, dietary requirements, housing/caging/equipment, medical conditions, behaviour issues. Tell us about their favourite things or routines to the best of your knowledge.

Do you need a carrier(s)? If so, how many? *

Cats MUST have a secure carrier to travel in. If you do not have one, we will arrange to get one to you before travelling with the cat(s).

If your pet is a dog, are they crate/kennel trained? *

• Yes
• No
• N/A

Will you be providing any supplies for your pet(s) such as food, equipment, crate, bedding, collars? *

• Yes
• No

Please list items...

REFERRAL AGENCY

Agency Name *

Contact Person *

Agency Phone *

Agency Email *

COMMUNICATION

Who will be the primary contact while pet(s) are in Paws for Hope’s care? *

• Myself
• Other

Please provide contact information if different from above.

Contact Name

First

Last

Contact Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Contact Phone

Contact Email

AUTHORIZED PARTY

Please provide the name and phone number of someone you authorize to act on your behalf, should you be unable to be contacted or to provide instructions or information to a representative of Paws for Hope Animal Foundation (Paws for Hope). Should you be unable to reunite with your pet and provide instructions for its permanent care, this person may be asked to provide such instruction. If a contact is not provided and Paws for Hope is unable to contact you within one month of the end date of the placement, pet(s) will be considered abandoned and Paws for Hope shall become the legal owner of said pet with all rights to the future of said pet(s).

Authorized Party Name *

Relationship *

Authorized Party Phone *

Authorized Party Email *

AGREEMENT

Today's Date

Date

Time

Request for Service Agreement

• By completing this Request for Service Agreement, I confirm that the information contained herein is true.

Submit