Community Outreach Request Form

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This form is to be completed for any non-urgent visits in the community. It might take several weeks for these requests to be completed. If the request is urgent and needs immediate attention (no food/water/shelter or pet(s) are sick or injured, please submit the Animal Control Request form instead.

Examples might include:

1) Pet owners who may need some additional support or coaching to achieve a more optimal level of care for their pets. They meet all standards of the law (food, water, shelter), but through relationship building, we have an opportunity to improve the pet(s)' quality of life.

2) Owners that change their mind about spay/neuter or are undecided but really just need a few encounters or phone conversations to reassure them or develop a rapport.

3) People whose phone numbers no longer work, whose voicemails are full, and/or they don't return texts and need a drive by to schedule an appointment. (GPG may send letter in lieu of a visit depending on bandwidth.)

4) Pet owners that may have mental health issues or substance abuse issues and need in-person evaluation or set up. They may be highly interested in our services, but just are difficult to communicate with by phone.

Note: A receipt from this form is not sent to the client after completion.

Type of request *

Neighbor or concerned citizen requesting outreach visit

GPG staff member requesting outreach visit

GPG volunteer requesting outreach visit

Other:

Requester's last name

Requester's first name

Would requestor like to remain anonymous? *

Yes

Other:

Requester's phone number (include area code)

Requester's email address

Requester's address

Requestor's zip code

Type of outreach request

General welfare check

Spay/neuter pre-visit or follow-up

Extreme weather

Other:

Clear selection

Street address to be visited *

Zip code to be visited *

62201

62202

62203

62204

62205

62206

62207

Other:

Please provide details as to the reason for this request. *

Name of person who submitted this form *

What happens next?

This request will be added to the Outreach Visit list. We will prioritize visits based on type and "urgency" of the request, but it can take us a couple of weeks to complete any given outreach request.

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