Intake Request Form

First Name *

Last Name *

Your Address *

City *

State *

Zip Code *

Home Phone Number

Mobile Phone Number

Email Address *

Number of cats in need of help *

Address where cat(s) found *

Are you providing food and/or shelter? *

How long have you been caring for the cat(s)?

Is the cat(s) located somewhere safe? (Barn, shed, enclosed porch, etc)? *

The cat (Please check all that apply): *

Please provide a description of the cat(s) needing help (ear tipped, color, fur length, adult, kitten, etc): *

Does the cat(s) appear to be sick, injured, or pregnant? *

Have you contacted your local shelter/animal control? *

When did you contact them and what was the outcome?

Has the cat(s) been scanned for a microchip? *

Have you checked with neighbors to see if this is someone's pet? *

Have you created a found AD on RI Lost Pets? *

If provided with the tools and instructions, are you able to help with trapping? *

Are you able to provide food and shelter if the cat(s) cannot be socialized and have to be returned after spay/neuter? *

Is there anything else we should know about the cat(s)?

By signing this intake request, I agree to the following: All statements made on this request are truthful; I have made no false statements with regard to the cat(s) I'm seeking help for and any other statements made on this request. *

Electronic Signature *