Small animal Pre-Admission Form - Borders Pet Rescue

Name of owner (required)

Address (required)

Town (required)

Postcode (required)

Telephone (required)

Email address (required)

Name of animal/s (required)

Species of animal (required)

Breed of animal

Age of animal (required)

Sex of animal (required)

Male

Female

Unknown

Is the animal neutered (required)

Yes

No

Unknown

Is the animal vaccinated (required)

Yes

No

Unknown or N/A

Date of last vaccination (required)

Is the animal microchipped (required)

Yes

No

Unknown

If not microchipped, or details not in your name, why/who is the dog registered to

What/when is the animal currently fed (required)

Where does the animal live (required)

Inside

Outside

Both

What is the animals current hutch/pen

Is the animal used to other animals (required)

Yes

No

If yes, please explain

Has the animal lived with children (required)

Yes

No

Unknown

Does the animal get on with children (required)

Age of children lived with/used to (required)

Any behavioural issues (required)

Any medical issues (required)

Reason for rehoming (required)

How long have you owned the animal (required)

Where did you get the animal from (required)

If a breeder/rescue, have you been in touch with them (required)

Are you able to bring the animal into us (required)

Yes

No

If more than 1 animal, should they be rehomed together (required)

Together

Seperate

Either

Any other comments

I confirm that I have read the Borders Pet Rescue Privacy Statement

(see below)

Type the characters (required)