Prospect Intake Form Please enable JavaScript in your browser to complete this form.Email *Date *Animal's Name *Animal's age *Animal's date of birth (approx.) *Gender *MaleFemaleSpayed/Neutered or intact? *SpayedNeuteredIntactDeclawed? *YesNoUnsureDisposition *FriendlySemi-FriendlyWildOtherIf other, please specify.Breed/Description *Reason for requesting Forgotten Felines and Fidos, Inc. intake this animal *We have a large number of cats in our care and limited space for new intakes. Please be aware that while we may not be able to intake your cat at this time, we will do our best to help you. When applicable, one of our volunteers will contact you within a week to discuss your situation.What is the urgency for Forgotten Felines and Fidos, Inc. to help this animal *1 (more than 4 weeks)2(more than 3 weeks)3 (more than 2 weeks)4 (more than 1 week)5 (URGENT)On a scale of 1-5 , with 1 representing more than 4 weeks until help is needed and 5 is urgentList any known medical treatment ( vaccinations, health checks, etc.) *Provide written documentation from a veterinarian If possiblePlease list a time frame of specific date that the animal caretaker can no longer care for the animal *Name *FirstLastAddress *Address Line 1Address Line 2City--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeHome phone # (if applicable) *Cell phone # (if applicable) *Age Range12-17 years old18-24 years old25-34 years old35-44 years old45-54 years old55-64 years old65-74 years old75+ years oldSelect your age range from the drop down menuSignature *Person completing this formPhoneSubmit
