Resources Adopters Animal Rehoming Animal Welfare Partners Community Cats Trap-Neuter-Return Program For Pet Parents Cats Dogs Resources to Help Care For Your Pet Report Animal Cruelty Veterinary Center Home Resources Animal Rehoming West Midtown Admissions ApplicationWest Midtown Admissions Application Please fill out the below form and a team member will be in contact with you. Name(Required) First Last Address(Required) Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code County of Residence(Required) Email(Required) Enter Email Confirm Email Phone(Required)Date of Birth(Required) MM slash DD slash YYYY Did you adopt your animal from AHS?:(Required) Yes No Animal Name:(Required) Cat or Dog?(Required) Cat Dog Age (years, months, weeks):(Required)Please be as specific as possible, and be sure to indicate whether the age is in years, months, and/or weeks. Size:(Required)Small (0-22lbs)Medium: (23-44lbs)Large (45-65lbs)Extra Large (66lbs+)Gender:(Required) Male Female Spayed/Neutered?(Required) Yes No Unknown Breed(Required) Primary Color:(Required) Secondary Color: Has your animal bitten anyone in the past 10 days?(Required) Yes No If yes, please explain:Is your pet microchipped?(Required) Yes No Unkown If yes, what is the microchip number:(Required) Length Owned:(Required) Where did you originally get your animal?:(Required) Reason for surrender:(Required)CAPTCHACommentsThis field is for validation purposes and should be left unchanged.