First and Last Name
*
Pronouns (she, he, they)
Phone
(###)
###
####
Email
*
Address (specify if mailing address only)
Is there anyone (over the age of 18 years old) who shares ownership of your pet(s) and can make decisions for care?
Has your pet(s) been seen by a PAW Team veterinarian before? Is so, when?
Which best describes your current housing situation?
How many individuals make up your household (those you live or travel with AND share your income)?
What is the average monthly income for your household?
Do you or anyone in your household receive one or both of the following benefits?
Are you willing to provide relevant paperwork regarding your household's income if asked?
Please list the name, breed, age, sex and color of the FIRST pet you are currently seeking services for.
PAW Team can only provide ongoing care to 2 animals per household, at one time.
Is this pet spayed or neutered?
If not, are you interested if services are available? If not, why?
Please describe your pet's symptoms or the concerns you are seeking care for.
If you are seeking services for a second pet, please list the name, breed, age, sex, and color of this pet.
PAW Team can only provide ongoing care to 2 animals per household, at one time.
Is this pet spayed or neutered?
If not, are you interested if services are available? If not, why?
Please describe your pet's symptoms or the concerns you are seeking care for.
If there are other pets in your household that your are responsible for providing care for, please list their name, breed, and age.
Keep in mind, we are limited as to the number of pets we can see per household, but if your pet(s) is not listed at this time, we may be unable to provide care to them in the future.
Thank you. Your request for services has been submitted. You will receive an initial response from PAW Team with next steps within a few weeks.
Please note: PAW Team does NOT provide emergency or urgent care.
