Wildlife Relinquishment Form Name * First Name Last Name Email * Phone * (###) ### #### How did you hear about us? Wildlife Rehabber Another Veterinary Clinic Word of Mouth Online Other Type of Animal * Bird Raccoon Squirrel Other If other, please specifiy When did you find the animal? * MM DD YYYY What time did you find the animal? * Hour Minute Second AM PM Where did you find the wild animal? * Please provide as much detail as possible (Address, Type of Area, Hidden/Exposed, etc... ) How did you find the animal? Has the animal been offered food or water? If yes, please specify what has been offered. Was the animal attacked? No Yes: dog attack Yes: cat attack Yes: other Did the animal bite or scratch anyone? Yes No Thank you!
