Animal Intake For internal use by STH only This form is meant to provide quick information about an animal within 24 hours of intake.Your name*Intake date* MM DD YYYY Animal's name*This can be changed laterSpecies*CatDogOtherOther species*Gender*MaleFemaleDon't know yetAlready spayed/neutered?*YesNoDon't know yetColor(s)*Breed*Best guess for nowAge*Best guessAge is in*yearsmonthsweeksdaysWhere did the animal come from?*ShelterReturnOther (Special Exception)What shelter?*Brownstown Animal ShelterDearborn Animal ShelterDetroit Animal Care and Control (DACC)Downriver Central Animal Control (DCAC)Flat Rock Animal ShelterLincoln Park Animal ShelterMacomb County Animal ControlMonroe County Animal ControlRiver Rouge Animal ShelterTaylor Animal ShelterWarren Animal ControlWyandotte Animal Control (WAC)OtherWhat other shelter?*What's the reason for the return?*Other from where?*Please briefly describe the circumstance*Did STH pull the animal's mom as well?YesNoWhat is her name?Does the animal have siblings?YesNoWhat are the names of the sibling(s)?Intake notesOptional (note things like heartworm positive, definitely needs dental, super smelly, etc.)Photo of pull form page 1Please upload if availablePhoto of pull form page 2Photo of pull form page 3Quick photo of animalOptional (does not have to be good photo)Please note that you'll be able to give a description and other information later. This is meant to be a quick way to track intakes. Δ
