Complete this form to request HAVA to bring an animal into our care.

About You
Intake Request

I agree to the following:

  • I certify that the above information I have given is accurate and truthful and I authorize a HAVA member to verify any and all information in this request.
  • I certify that either I am the owner or to the best of my knowledge, no other person has any right to this animal.
  • I hereby surrender all rights to this animal.
  • I understand that once I relinquish the animal, the animal will not be available to be returned.

By submitting this form electronically you understand the the terms of this request.

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