SVASC Animal Assessment Form Phone Name of Animal * Type * Cat Dog Other Age * under 1 year 1-5 years 6-9 years 10+ years Priority Assessment * Low Medium High Urgent Health Issues Behavioral Issues Has a vet seen them? * Yes No Not sure Gender * Male Female Spayed/Neutered * Yes No Pending If a dental is being requested, does the animal have any of the following: Bleeding in the mouth Injury to mouth Broken teeth Sign of infection Swelling Inability to eat Adoptability Rating * 1-Low 5-High Photo Upload
