Members: Intake

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Intake date:*

Your name:*

Email:*

Dogs name:*

Dogs age:*

Dogs sex/altered:*

Color:*

Purebred, mix, describe:

Where did the dog come from? Example: private party (owner relinquish) or name of shelter and impound#:*

Microchip brand and number:*

Where are they being fostered or boarded:*

Any major medical needed?:

1. Upload any files or photos of the dog here:

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Maximum file size: 2mb.

2. Upload any files or photos of the dog here:

3. Upload any files or photos of the dog here:

4. Upload any files or photos of the dog here:

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Members Access