Small Animal History Form Small Animal History Form Owner InformationYou need to surrender your pet to the OHS because: * Required Moving and unable to bring pet (please provide moving date below) Cost of having a pet Pet is injured/ill (please provide more information below) Pet is aggressive Behaviour issue Too many animals Not enough time Pet is house soiling Other (please provide more information below) Prefer not to say Are you surrendering your pet for end of life care (humane euthanasia)? * Required Yes No Please provide your moving date. * RequiredPlease provide more details of your pet's injury/illness. * RequiredPlease provide your reason for needing to surrender your pet. * RequiredYour Name * Required First Last Email * Required Phone Number * Required Address * Required City * Required Province * RequiredONQCPostal Code * Required Information About Your PetName * Required Age * Required Species * Required Gender * RequiredFemale (spayed)Male (neuter)Female (unaltered)Male (unaltered)Not SureDo you know of any past or current medical conditions? If yes, what are they? * RequiredIs your pet currently on medication? If yes, please specify. * RequiredIs your pet currently on a special diet? If yes, please specify. * RequiredWhat is the name of your pet's veterinarian? Your Pet's HistoryHow long have you owned your pet? (Number of years, months, etc.) * Required How did you acquire your pet? * Required Ottawa Humane Society Found them outside Pet Store Friend or relative Online Placement Group An animal shelter that wasn't the Ottawa Humane Society Breeder Please share the name of the shelter, breeder or placement group. * Required Has your pet lived with other pets? * Required Yes No Don't know What species and did they get along? * RequiredDoes your pet like to be handled (petted, picked up, held)? * Required Yes No Don't know Has your pet lived with children? * Required Yes No Don't know What age of children? * Required How does your pet behave around children? * Required Has never met children Comfortable around active children Comfortable around calm children Avoids children Where does your pet live in your home? * Required A cage Free run How often do you let your pet out for exercise? * Required Daily Two (2) to four (4) times a week Weekly Occasionally Never What do you feed your pet? * RequiredHow often do you feed your pet daily? * Required Once Twice Three times or more How much do you feed your pet at each feeding? * Required Is your pet litter trained? * Required Yes No What type of litter do you use? * Required How often do you clean your pet's litter? * Required Daily Twice a week Once a week Occasionally Is your pet: * Required Friendly Calm and relaxed Playful and active Social Shy and timid Nervous Quiet Has your pet bitten a person? * Required Yes Yes, and drew blood No What caused the bite (handling, fear, etc.)? * RequiredDoes your pet have any special habits?I understand that some animals have medical or behaviour issues that make them difficult or impossible to rehome, and the OHS will not adopt out any animal believed to be a public safety risk. Additionally, some animals become highly stressed in a shelter environment, which makes them more susceptible to illness and, despite aggressive veterinary treatment, unlikely to recover from such illness. The OHS will not keep an animal in a state of suffering when their prognosis is poor or when the OHS lacks the resources to restore the animal’s health. I understand that these animals will be humanely euthanized by caring, professional staff. The OHS does not humanely euthanize healthy, adoptable animals regardless of length of stay or lack of space. * Required I agree I understand that I will need to provide proof of ownership for the animal being surrendered, such as City of Ottawa registration, a bill of sale, a receipt from my veterinary clinic, or photos. * Required I agree I understand that I will need to provide a piece of photo identification for myself at the surrender appointment. * Required I agree Is there any additional information you would like to share with us?If possible, please provide your pet's veterinary records.Accepted file types: pdf, Max. file size: 8 MB.If possible, please provide a photo of your pet. (JPEG format)Accepted file types: jpg, Max. file size: 8 MB. Δ
Small Animal History Form Owner InformationYou need to surrender your pet to the OHS because: * Required Moving and unable to bring pet (please provide moving date below) Cost of having a pet Pet is injured/ill (please provide more information below) Pet is aggressive Behaviour issue Too many animals Not enough time Pet is house soiling Other (please provide more information below) Prefer not to say Are you surrendering your pet for end of life care (humane euthanasia)? * Required Yes No Please provide your moving date. * RequiredPlease provide more details of your pet's injury/illness. * RequiredPlease provide your reason for needing to surrender your pet. * RequiredYour Name * Required First Last Email * Required Phone Number * Required Address * Required City * Required Province * RequiredONQCPostal Code * Required Information About Your PetName * Required Age * Required Species * Required Gender * RequiredFemale (spayed)Male (neuter)Female (unaltered)Male (unaltered)Not SureDo you know of any past or current medical conditions? If yes, what are they? * RequiredIs your pet currently on medication? If yes, please specify. * RequiredIs your pet currently on a special diet? If yes, please specify. * RequiredWhat is the name of your pet's veterinarian? Your Pet's HistoryHow long have you owned your pet? (Number of years, months, etc.) * Required How did you acquire your pet? * Required Ottawa Humane Society Found them outside Pet Store Friend or relative Online Placement Group An animal shelter that wasn't the Ottawa Humane Society Breeder Please share the name of the shelter, breeder or placement group. * Required Has your pet lived with other pets? * Required Yes No Don't know What species and did they get along? * RequiredDoes your pet like to be handled (petted, picked up, held)? * Required Yes No Don't know Has your pet lived with children? * Required Yes No Don't know What age of children? * Required How does your pet behave around children? * Required Has never met children Comfortable around active children Comfortable around calm children Avoids children Where does your pet live in your home? * Required A cage Free run How often do you let your pet out for exercise? * Required Daily Two (2) to four (4) times a week Weekly Occasionally Never What do you feed your pet? * RequiredHow often do you feed your pet daily? * Required Once Twice Three times or more How much do you feed your pet at each feeding? * Required Is your pet litter trained? * Required Yes No What type of litter do you use? * Required How often do you clean your pet's litter? * Required Daily Twice a week Once a week Occasionally Is your pet: * Required Friendly Calm and relaxed Playful and active Social Shy and timid Nervous Quiet Has your pet bitten a person? * Required Yes Yes, and drew blood No What caused the bite (handling, fear, etc.)? * RequiredDoes your pet have any special habits?I understand that some animals have medical or behaviour issues that make them difficult or impossible to rehome, and the OHS will not adopt out any animal believed to be a public safety risk. Additionally, some animals become highly stressed in a shelter environment, which makes them more susceptible to illness and, despite aggressive veterinary treatment, unlikely to recover from such illness. The OHS will not keep an animal in a state of suffering when their prognosis is poor or when the OHS lacks the resources to restore the animal’s health. I understand that these animals will be humanely euthanized by caring, professional staff. The OHS does not humanely euthanize healthy, adoptable animals regardless of length of stay or lack of space. * Required I agree I understand that I will need to provide proof of ownership for the animal being surrendered, such as City of Ottawa registration, a bill of sale, a receipt from my veterinary clinic, or photos. * Required I agree I understand that I will need to provide a piece of photo identification for myself at the surrender appointment. * Required I agree Is there any additional information you would like to share with us?If possible, please provide your pet's veterinary records.Accepted file types: pdf, Max. file size: 8 MB.If possible, please provide a photo of your pet. (JPEG format)Accepted file types: jpg, Max. file size: 8 MB. Δ
