Small Mammal QuestionnaireWe understand that the decision to surrender a pet is not easy. We do our best to help every person that comes to us. Sometimes, there are better re-homing options, and we may recommend other resources, depending on your pet’s needs. Here is a link to other organizations in the area. We are a private, non-profit, no-kill shelter with a 98% live release rate. We operate on an appointment-based schedule, and operate on a waitlist. Once a small mammal is adopted, we will contact you to get more information and discuss next steps. If you need immediate assistance, we recommend contacting your municipal shelter. If you are returning a pet within 2 weeks of adoption, we can usually offer an appointment within 48 hours of receiving this form. We have a few questions that will help us assist you and your pet. Please be as detailed as possible when answering. Once we have received your questionnaire we will be in touch (usually by phone) to get more information and discuss next steps. Your Name* First Last Your preferred name Pronouns he/him, she/her, they/them, ze/hir, etc.Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Can we send a detailed email to this address?* Yes No Phone*Can we leave a detailed message at this number?* Yes No Are you the owner of this animal?* Yes No Please provide full name and contact information of the ownerGeneral InformationWhy are you surrendering your animal?*What efforts have you taken to re-home your animal?*What is your timeline for surrendering* Less than 1 week 1-2 weeks 2 weeks - 1 month Greater than 1 month Seattle Humane is usually scheduling 1-2 weeks in advance. If you need immediate assistance, please contact your municipal shelter. Species* Rabbit Guinea Pig Rat Chinchilla Mice Hamster Gerbil Animal's Name* Age* please include units - i.e. yearsBreed(s)* Color(s)* Sex* Male Female Unsure Spayed or neutered?* Yes No Unsure Is your pet microchipped?* Yes No Unsure Microchip number if known HistoryHow long have you had your pet?* Please include units - i.e. yearsWhere did you get your pet?* Ex: friend, craigslist, stray, breeder, pet store, etcHas your pet seen a veterinarian?* Yes No Unsure Name of vet or clinic We will contact your vet to obtain medical records. This helps us triage incoming animals and have a thorough picture of how to best serve you and your pet.Phone number of vet or clinicHow is your pet around people he/she knows?*Has your pet ever bitten a person?* Yes No Please select yes if your pet has done this, even if they didn't break skinHas your pet fought with, injured, or bitten another small mammal?* Yes No Please select yes if your pet has done this, even if they didn't break skinDoes your pet have any current medical conditions?* Yes No Unsure Please explain any medical conditionsHas your pet ever had any of the following* Fleas Ticks Fur mites Ear mites Dental/teeth problems Skin problems Runny eyes Runny nose Sneezing Digestive/G.I. problems None Check all that apply, even if not currentOptional: Upload a photo of your petMax. file size: 50 MB.
