Animal Intake Request Form

This form is for animals being surrendered to the Bermuda SPCA or for reporting a stray animal. Please provide as much information as possible. Honest answers will not affect whether we are able to assist, but they will help us better understand the animal's needs, provide appropriate care, and improve their chances of finding a suitable home. Please complete one form per animal. If you need to surrender or report multiple animals, a separate form must be submitted for each one, as the information may differ and each form is attached to the individual animal's record.

For emergencies please call 236-7333.

Owner Information Please provide your contact information so we can contact you regarding your request.
First Name *
Last Name *
Home Phone
Mobile Number *
Home Address (where the animal currently resides) *
Email * Please ensure this email address is accurate and checked regularly, as we may use it to contact you.
Animal Information Please provide information about the animal requiring assistance.
How long have you owned or cared for this animal? *
Animal Name *
A photo of your animal *
Type of Request *	Select I need to surrender my animal I have found a stray animal I am reporting an abandoned animal
Species *	Please Select Dog Cat Rabbit Bird Guinea Pig Hamster Chinchilla Other
Is the dog licensed? *	Please Select Yes No Not Applicable
Is this animal spayed or neutered? *	Please Select Yes No Unknown
Breed * For mixed breeds, please enter "crossbreed" if unknown. For cats, please indicate Domestic Shorthair, Domestic Longhair, or specific breed if known.
Colour *
Age of animal (please state whether this in months or years) *
Further description *
Sex *	Please Select Male Female Unknown
Does this animal have any special care, housing, dietary, or handling requirements? * Examples: specific housing needs, dietary requirements, bonded companions, exercise requirements, environmental sensitivities, or handling considerations.
Has the animal ever shown signs of aggression (you can select more than one) *	Please Select all that apply No known history of aggression Growling Snapping Biting Resource guarding (food, toys, or other items) Hissing or swatting Fearful or defensive behaviour Other
Please provide details about any aggressive or concerning behaviour.
How does this animal react to the following situations? (Select all that apply) *	Enjoys being handled Tolerates being handled Reacts defensively when handled Enjoys being groomed or brushed Tolerates grooming or brushing Reacts defensively during grooming or brushing Enjoys being picked up Tolerates being picked up Reacts defensively when picked up Enjoys veterinary visits Tolerates veterinary visits Reacts defensively at veterinary visits Enjoys nail trims Tolerates nail trims Reacts defensively during nail trims Unknown Other
How does this animal behave during veterinary visits? (Select all that apply) *	Friendly and relaxed Tolerates examinations and handling Nervous but manageable Shy or withdrawn Fearful Resists handling Growls Snaps Attempts to bite Requires a muzzle Has been sedated for procedures Vocalises during examinations Does not appear bothered Has never visited a veterinarian Unknown Other
Please provide any additional details that would help staff safely handle this animal during veterinary care.
Reason you are giving up the animal *	Please Select Found as a Stray Behaviour Concerns Animal Does Not Get Along With Other Pets Financial Difficulties Housing / Rental Issues Moving Leaving Bermuda Owner Health Issues Owner Hospitalized Owner Incarcerated Animal Left Behind by Family Member Animal Left Behind by Tenant Allergies Too Many Pets Animal Escaping / Roaming Baby or New Family Circumstances Unable to Continue Care Other
Please provide additional details about your situation and the animal. *
Is there anything that could be done to help keep this animal in your home? Examples: pet food assistance, behavioural support, veterinary assistance, or other support.
Has this animal lived with cats? *	Please select Yes, has lived with cats and played and hung out together Yes, has lived with cats but ignored each other Yes, has lived with cats but didn't work well No, hasn't lived with cats
Has this animal lived with one or more dogs *	Please select Yes, has lived with dogs and played and hung out together Yes, has lived with dogs but ignored each otehr Yes, has lived with dogs but didn't work well No, hasn't lived with dogs
When was the animal last vaccinated by a veterinarian? *	Please Select Within the last 12 months More than 12 months ago As a puppy or kitten only Never vaccinated Unknown Not Applicable
Has the animal lived with kids? *	Please Select Yes, has lived with kids No, hasn't lived with kids Has regular contact with visiting kids Unknown
What age(s) of children has the animal lived with? *	Please Select Under 5 years 5-12 years 13-17 years All ages Unknown
Where did you get the animal from? *	Please Select Found as a stray Caring for a stray animal My animal had babies From a friend From a family member From the Bermuda SPCA From CATS From the Animal Wardens From JAM Pups From a breeder From a pet shop Moved to Bermuda with me Imported from overseas Other
If obtained from a pet shop, please specify which one. *	Please Select Pic A Pet Paws and Claws (Somerset) Pet Stop (Mills Creek) Other
Where at home does the animal live right now? *	Please Select Lives primarily indoors Lives indoors and outdoors Lives in a kennel Lives in a yard (not chained) Lives on a chain Outdoor only (cat) Other
May we share your contact details with potential adopters if appropriate? * This is at our discretion and will only be done for neutered animals.	NoYes
Is there anything else you would like us to know about this animal?
Dog Information Please answer the following questions about your dog's behaviour, routine, and care.
Would you recommend placing this dog in a home with children under 8 years of age? *	Please Select Yes No Not Sure
If No or Not Sure, please explain.
Would you recommend placing this dog in a home with other dogs? *	Please Select Yes No Not Sure
If No or Not Sure, please explain.
Would you recommend placing this dog in a home with cats? *	Please Select Yes No Not Sure
If No or Not Sure, please explain.
Please describe this dog's experience with other animals. Examples: friendly with other dogs, ignores cats, chases birds, lived with rabbits, fearful of other animals, plays well with dogs, etc.
Has this dog ever escaped or run away? *	Please Select Yes No
If yes, please describe how the dog escaped or ran away.
Are there any people, animals, objects, or situations that this dog appears to be afraid of? *	Men Women Children Dogs Cats Strangers Loud noises Thunderstorms Vehicles Vacuum cleaner Water Other None known
Are there any situations that may cause this dog to growl, snap, lunge, or react aggressively? * Examples: food, toys, strangers, handling, other animals, children, being startled, veterinary visits, etc.
Are there any places on the dog's body where it does not like to be touched? *	Feet/Paws Nails Legs Tail Back Neck/Collar Area Ears Mouth Face Abdomen/Belly Hips/Hind End Does not like to be brushed Does not like to be picked up No known sensitivities Other
Please provide additional details.
Does this dog have any current, previous, or recurring medical or behavioural concerns? * Please include any medical conditions, injuries, allergies, anxiety, fears, reactivity, behavioural concerns, or other ongoing issues.
Is this dog currently taking any medication? *	NoYes
Please list all medications and what they are used for.
What brand and type of food is this dog currently eating?
What type of training has this dog received?	Group obedience classes Private training sessions Trained at home No formal training Unknown Other
What cues does this dog know?	Sit Stay Come Down Leave it Heel Paw/Shake Crate Place/Bed Other
What are this dog's favourite toys, activities, or forms of enrichment? Eg: fetch, swimming, food puzzles, KONGs, squeaky toys, tug toys, car rides, playing with other dogs, etc.
Cat Information Please answer the following questions about your cat's behaviour, routine, and care.
Does this cat consistently use a litter box? *	Please Select Yes No Sometimes Unknown
If No or Sometimes, please provide details.
What is this cat's interaction with dogs?	Please Select Friendly with dogs Tolerates dogs Ignores dogs Fearful of dogs Avoids dogs Aggressive toward dogs Has never lived with dogs Unknown
Please provide additional details.
What is this cat's interaction with other cats?	Please Select Friendly with other cats Tolerates other cats Ignores other cats Fearful of other cats Avoids other cats Aggressive toward other cats Prefers to be the only cat Has never lived with other cats Unknown
Please provide additional details.
Would you recommend placing this cat in a home with children?	Please Select Yes No Not Sure
If No or Not Sure, please explain.
Please select any that apply to this cat.	Destroys furniture Destroys houseplants Urine marks/sprays Goes outside Uses a scratching post Plays with toys
Does this cat have any current, previous, or recurring medical conditions? * Please include any illnesses, injuries, allergies, ongoing treatments, or other medical concerns.
Is this cat currently taking any medication? *	NoYes
If yes, please list all medications and what they are used for.
Is this cat declawed?	Please Select No Yes - Front paws only Yes - All four paws Unknown
What are this cat's favourite toys, activities, treats, or forms of enrichment? Examples: wand toys, laser pointers, catnip, treats, puzzle feeders, climbing towers, window watching, brushing, etc.

Please Note: Submitting this form does not guarantee immediate intake. Requests are reviewed regularly and animals may be prioritised based on welfare needs and available shelter space. We are unable to provide an estimated intake date. If your circumstances change after submitting this form, please let us know. Thank you for helping us gather the information needed to support your animal.