RAIN Profile

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Tell Us About Yourself

Name *

First

Last

Phone *

Email *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Tell Us About Your Pet

Pet's Name: *

Pet's Age: *

Length Owned: *

What Type Of Pet Do You Have? Select One: *

Dog
Cat
Other

Why Do You Need to Rehome Your Pet? *

Has Your Pet Ever Bitten or Scratched Another Animal, Drawing Blood? *

If Yes, Please Explain The Situation:

How Does Your Pet Respond To Other Animals In The Home, In General? Select All The Apply: *

Has not lived with other animals
Friendly
Playful
Tolerant
Ignores
Growls
Chases
Hides
Attacks

How Does Your Pet Respond To Cats In The Home? Select All The Apply: *

Has not lived with cats
Friendly
Playful
Tolerant
Ignores
Growls
Chases
Hides
Attacks

How Does Your Pet Respond To Dogs In The Home? Select All The Apply: *

Has not lived with dogs
Friendly
Playful
Tolerant
Ignores
Growls
Chases
Hides
Attacks

Please List Any Animals That Lived In Your Home With Your Pet At Any Time: *

Please Describe In Your Own Words How Your Pet Interacts With People In The Home And Outside The Home: *

If Yes, How Old And How Were Their Interactions?

Has Your Pet Ever Lived With Children Under The Age Of 18? *

Medical

Is Your Pet Spayed Or Neutered (fixed)? Your pet must be fixed to participate in this program. Selecting no will disqualify you and your pet from entering the RAIN Program. Select One: *

Which Veterinarian Do You Use? *

Is Your Pet On Any Medications? Select One: *

Please Attach Historical Vet Records Indicating Vaccination Status And Spay/Neuter Proof (.pdf, .doc): *

Drag & Drop Files, Choose Files to Upload

Signature

Clear Signature

Is Your Pet Declawed (cats only)? Select One: *

Do You Give Us Permission To Contact Your Veterinarian For Additional Information? Select One: *

If Yes, Please List Medications And Conditions:

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RAIN Profile

Tell Us About Yourself

Tell Us About Your Pet

Medical

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