Forms

'''           DRAFT Forms for Animal Transfer ''' Note: These draft forms will be streamlined for easy printing.

Summary

These forms are for accepting, transporting, and releasing animals to destination rescues, adoptions or foster homes and for setting standards of care while animals are the responsibility of ACT and its representatives.


 * 1. Letter of Agreement (between ACT & releasing group)


 * 2. Master Tracking Form one per animal, for acceptance, transport and release, includes the following forms:
 * 2.1 Acceptance Form for each animal (copy to releasing organization)
 * 2.2 Transport Form for each animal (copy to transporters)
 * 2.3 Release Form for each animal (copy to Rescue, Foster, or Adopter)


 * Tracking forms stays with animals until animals are released to new owners, and then the original forms are forwarded to the ACT secretary at: (details needed)


 * 3 Standards of Care (for use by ACT & transporters & foster providers)

The forms can be printed with or without data from a web database. The web database can be updated from the printed forms that have been completed in the field.

= Letter of Agreement =

The Letter of Agreement is a template for writing the terms for accepting animals from a shelter or rescue. Blank spaces indicate data needed for completing individual agreements.

Agreement template should include spaces for:
 * Names and addresses of parties to the agreement
 * Start and end dates for agreement
 * Terms for renewing agreement
 * Terms for terminating agreement
 * Number of animals to be accepted for set periods
 * Types of animals to be accepted
 * Preparation of animals to be accepted
 * Documentation for animals to be accepted
 * Required data items, such as species, breed, age, gender
 * Ownership of animals
 * Health certificates
 * Vaccination records
 * etc.

= Master Tracking Form = Master Tracking Form objectives:
 * Include subforms 2.1, 2.2, & 2.3
 * Brevity
 * Animal chain of custody from acceptance to release
 * Check off list for work flow and animal care
 * Record subform copies to responsible parties
 * Completed forms used to update web database
 * Forms to be printed from web database with or without data

Colophon:
 * Bold text - required items
 * Italic text - desired items
 * Plain text - optional items

Acceptance Form
ANIMAL PASSENGER:

Basic information

 * ACT assigned animal ID:________________
 * Pickup location:
 * Name:
 * Species:
 * Breed:
 * Age:
 * Sex:
 * Spayed/Neutered?
 * Size/weight:
 * With collar?
 * Collar/tag information:




 * Animal relinquished by
 * Signature ______________________________________
 * Print name _____________________________________
 * Initial if copy of this form is provided [______]
 * Animal & original form is received for transport by
 * Signature ______________________________________
 * Print name _____________________________________
 * Date: ________________________________
 * Animal & original form is received for transport by
 * Signature ______________________________________
 * Print name _____________________________________
 * Date: ________________________________
 * Print name _____________________________________
 * Date: ________________________________
 * Print name _____________________________________
 * Date: ________________________________
 * Date: ________________________________

Health information

 * Condition:
 * Fleas/Ticks/ Parasites:
 * Heart worm condition:
 * Medication:
 * Up to date on shots?
 * Heart worm preventative:
 * Flea control:

Behavior information

 * Does he/she get along with other animals?
 * Any behavior problems?

Transport instructions

 * Must be crated?
 * Special care instructions:

Trip plan

 * Trip ID:___________(increment from 0001 to 9999)
 * Start date:
 * End date:
 * Trip plans: http://act.wikia.com/wiki/Trip

Transport group

 * Group name:
 * Coordinator name:
 * Address:
 * Phone number:
 * E-mail address:
 * Web site:

Origination

 * Shelter/Rescue:
 * Contact name:
 * Address:
 * Phone number:
 * E-mail address:
 * Web site:

Destination

 * Receiving Rescue/Adoptive Home:
 * Contact name:
 * Address:
 * Phone number:
 * E-mail address:
 * Web site:


 * Animal delivered by
 * Signature ______________________________________
 * Print name _____________________________________
 * Initial if copy of this form is provided [______]
 * Animal & original form received by
 * Signature ______________________________________
 * Print name _____________________________________
 * Initial if Standards of Care is provided [______]
 * Date: ________________________________
 * Animal & original form received by
 * Signature ______________________________________
 * Print name _____________________________________
 * Initial if Standards of Care is provided [______]
 * Date: ________________________________
 * Print name _____________________________________
 * Initial if Standards of Care is provided [______]
 * Date: ________________________________
 * Date: ________________________________
 * Date: ________________________________

Release Form
Release Form includes policy and procedures for releasing animals to rescues; or for adoption; or for foster care.


 * 1) item
 * 2) subitem
 * 3) subsubitem
 * 4) subsubitem
 * 5) subitem
 * 6) subsubitem
 * 7) subsubitem
 * 8) item
 * 9) subitem
 * 10) subsubitem
 * 11) subsubitem
 * 12) subitem
 * 13) subsubitem
 * 14) subsubitem


 * Animal released by
 * Signature ______________________________________
 * Print name _____________________________________
 * Retains original form for ACT secretary
 * I accept animal under conditions listed above
 * Signature ______________________________________
 * Print name _____________________________________
 * Initial if copy of this form is provided [______]
 * Initial if Standards of Care is provided [______]
 * Address:
 * Telephone:
 * E-mail:
 * Date: ________________________________
 * Print name _____________________________________
 * Initial if copy of this form is provided [______]
 * Initial if Standards of Care is provided [______]
 * Address:
 * Telephone:
 * E-mail:
 * Date: ________________________________
 * Address:
 * Telephone:
 * E-mail:
 * Date: ________________________________
 * E-mail:
 * Date: ________________________________
 * Date: ________________________________
 * Date: ________________________________

= Standards of Care =

Standards of Care covers the care and feeding requirements for animals in the legal possession of ACT or ACT's representatives. Special care requirements should be included in the Master Tracking Form for individual animals.


 * 1) item
 * 2) subitem
 * 3) subsubitem
 * 4) subsubitem
 * 5) subitem
 * 6) subsubitem
 * 7) subsubitem
 * 8) item
 * 9) subitem
 * 10) subsubitem
 * 11) subsubitem
 * 12) subitem
 * 13) subsubitem
 * 14) subsubitem

= See also =
 * Trip plans

= External links =