Bermuda SPCA animal intake registration

BERMUDA SPCA - ANIMAL INTAKE REGISTRATION FORM. THIS FORM IS FOR THOSE NEEDING TO SURRENDER AN ANIMAL TO THE SHELTER OR BRING IN A STRAY. FOR EMERGENCIES, CALL 236 7333 Please give us as much information as possible. Truthful answers will not affect the animal's chances of coming in to us, but will improve the chances of fixing any issues and finding a home. Please also do not use this form more than once per animal. For multiple animals, please complete a form per pet. This is since the answers may be different for each animal and your form will attach to the animal's record.

Title *	Mr Mrs Ms Mx
Initials *
First Name *
Surname *
Home phone (put "don't have" if you don't have one) *
Cellphone(if you don't have a cell, put "don't have") *
Home Address (where the animal lives) *
Email (please ensure this is accurate and you monitor it, as we may use this to contact you) *
How long have you had the animal? *
animal's name *
Species *	Please Select Dog Cat Rabbit Bird other
Breed - for dogs, write the breed or if a cross, write "crossbreed". For cats, write "Shorthair," or "Longhair," or " semi-longhair" or write the specific breed *
Colour *
Age of animal (please state whether this in months or years) *
Further description *
Male or Female *	Please select Male Female Don't Know
Neutered or spayed? *	Please select Cat is Neutered Cat is Not Neutered Dog is Neutered Dog is Not Neutered Rabbit is Neutered Rabbit is Not Neutered Cat - Don't Know Dog - Don't Know Rabbit - Don't Know Other
Is the dog licenced *	Please select Yes-Licenced and has paperwork No-Not Licenced Don't know Not a dog
Has the animal ever shown signs of aggression (you can select more than one) *	Please select as many as apply No history of Aggression Dog has growled not bitten Dog has bitten adult once Dog has bitten child once Dog has bitten adult more than once Dog has bitten child more than once Dog is highly agressive over food or toys Cat has bitten Cat hisses and lashes out
Reason you are giving up the animal *	Please select Stray/Found Aggressive Allergy Animal left behind by family member Animal left behind by tenant Baby on way Can't afford vet cost Can't afford to keep Doesn't get on with other animals Keeps escaping Leaving Bermuda Moving apartment etc Owner gone into hospital Owner gone into prison Too many pets
More details about why you are giving up the animal *
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 (innoculations/"shots") by a vet *	Please select Within 12 months Within 2 years As a puppy or kitten Never been vaccinated
Has the animal lived with kids? *	Please select Yes, has lived with kids No, hasn't lived with kids Has visiting kids Don't know if has lived with kids
What age of kids did he/she live with? *	Please select 0-5yrs 5-12yrs 12-16yrs 0-12yrs 0-16yrs 5-12yrs
Where did you get the animal from? *	Please Select I found it! It's a stray I have fed for ages My animal had babies From a friend From a family member From the SPCA From CATS From the Animal Wardens From Jampups group From a breeder From a Pet Shop I brought it with me to Bermuda
If from a pet shop, which one *	Not applicable Pic A Pet Paws and Claws (Somerset) Petstop Mills Creek
Where at home does the animal live right now? *	Please select In the house In a kennel On a chain In the yard but not chained In the house but sometimes outside Outdoor only (cat) Other
Can we pass your contact details on to potential adopters? This is at our discretion and will only be done for neutered animals. *	NoYes
Briefly, why do you need to hand the animal to the SPCA *
Anything else you need to mention? *
A photo of your animal

Thank you for completing this form. What happens next: the details are on our waiting list which we review constantly. Staff will be in touch once a surrender spot becomes vacant. There is no need to call us. Please be aware that there will be other animals ahead of yours on the list, we also prioritise animals from our inspectorate work as well. As we do not euthanase to make room, it is impossible to give an accurate estimate of how long it may be before we can intake animals. You can increase the speed with which we can take the animal in, by ensuring your animal is fully up to date with vaccinations (any vet can advise you what these are) as vaccinated animals are easier to place within additional locations in the shelter. Thank you