Emergency Pet Food Assistance Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

This form is to collect information on pet owners who are seeking pet food assistance and have been affected by the COVID-19 crisis. The Haven, a non-profit, no-kill animal shelter is offering this service to Baldwin County, Alabama residents to help prevent these pet owners from surrendering or abandoning pets.

Please note that we do not ship pet food. All approved forms will need to pick up the pet food by appointment only. Location for pick-up will be shared with you at the time of scheduling the appointment. Email and texting is the preferred form of communication for us at this time. We cannot guarantee that we will have pet food in stock and we are unable to offer specific dietary pet food.

Pet owners are limited pet food assistance for up to two pets per household.

A valid ID will be required at the time of pick-up.

Thank you and stay safe.

First Name *

Last Name *

Email address *

Main Phone Number *

Alternate Phone Number *

Address Line 1 *

Address Line 2 *

City *

State *

Zip Code *

Select species. *

Cat

Dog

Required

Select pet age-appropriate pet food. *

Adult cat food

Kitten Food

Adult dog food

Puppy Food

Required

Why do you need Pet Food Assistance? Select all that apply. *

Loss of job due to company temporaty or permant closure caused by COVID-19

Reduction in work hours due to COVID-19

Stay at home to take care of children due to school closures

Medical/Crisis

Required

Will you receive any paid time off or other compensation from your employer if laid off temporarily? *

Yes

Doesn't apply to me

Submit

Clear form

Never submit passwords through Google Forms.

This form was created inside of The Haven.

Does this form look suspicious? Report

Forms