Form Center

2. I can keep this pet:*

   Check all that apply

   1. As long as it takes to find the owner
   2. For a few days only
   3. If EAS can provide me with supplies/food
   4. I cannot keep this pet for any length of time
   5. I'd like to adopt this pet if the owner isn't located
3. Supplies needed:*
5. Please contact me to make arrangements to bring the pet to EAS*

   1. No
   2. Yes
7. City pet was found:*
8. Address/cross streets pet was found:*
9. Date and time pet was found:*
   Date and time pet was found:

   Date and time pet was found:
11. What type of pet did you find?*

    1. Cat
    2. Dog
    3. Other
12. Species*
13. Condition of pet:*
    -- Select One --Appears healthyAppears sick or injuredDeceasedUnknownOther
15. Please explain:*
17. Does the pet you found have (please check all that apply)?*

    1. Microchip
    2. License
    3. Rabies tag
    4. Other I.D. tag
    5. No I.D.
18. License number and city/county
19. Microchip number
20. Rabies tag info
22. Other I.D. tag info
24. Is the pet you found wearing a collar?*

    1. Yes
    2. No
    3. Unknown
25. Describe collar
27. Sex*
    -- Select One --MaleFemaleUnknown
28. Spayed/Neutered*
    -- Select One --YesNoUnknown
30. Breed or mix*
31. Approximate size
    -- Select One --under 5lbsbetween 5-20lbsbetween 20-40lbsbetween 40-60lbsbetween 60-90lbsabove 90lbs
32. Approximate age*
    -- Select One --Newborn/unweaned babyWeaned puppy/kittenAdolescent/young adultAdultSenior adult
34. Tail*
    -- Select One --ShortMediumLongKinkedMissing DockedCurledOther
35. Describe tail*
36. Length of coat
    -- Select One --ShortMediumLong
37. Eye color
39. Ears
    -- Select One --ErectDroopyCroppedEar-tippedOther
40. Describe ears*
42. Colors and/or pattern*
44. Additional identifying features
46. Please attach a photo of the pet you found:
    Optional
48. First Name*
49. Last Name*
50. Date of Birth
    Date of Birth
52. Your Address*
53. Apartment/Unit#
55. Address2
57. City*
58. State*
59. Zip*
61. Phone Number*
62. Alternative phone number
63. Alternative phone number
65. Email address*
Leave This Blank:


67. 1. Receive an email copy of this form.
68. Email address

    This field is not part of the form submission.

69. Submit Submit and Print

* indicates a required field