HALT (Help Animals Lives Today) © 2011 - 2018
Website is developed and maintained by Website to the Rescue

Your Name
City, State, Zip
Home Phone
Cell Phone
Email Address
Your Date of Birth
Dog's Name
Approx. Age or Date of Birth
Spayed or Neutered?
(If Yes, please provide Spay/Neuter Certification)
Up to date on Vaccinations?
(If Yes, please provide all vaccinations records)
Special Dietary Needs:
Special Medical Care:
Please tell us anything you would like us to know about your pet, including special relationships with other pets
Your veterinarian's contact information: Name:


Phone Number:
Your temporary caregiver's contact information: Name:


Phone Number:
Your Executor or Personal Representative contact information: Name:


Phone Number:
Please list details of your financial arrangements for Help Animals Lives Today:

To Validate Human entry of this form, please answer the following question:

Is the picture below a dog, cat, or fish?


Gaining peace of mind for your beloved furry friends in the event something happens to you might be of great importance to you. To alleviate those concerns, we have created a Lifetime Care Program to help you.

We are in a position to accept your pets based on the decision you might reach. Have it adopted out to a new loving family, who will take care with the same compassion you have, or have it remain in our no kill sanctuary with the same loving care. So the legacy of kindness depends on you, how to share your love with animals.

There are many options  which you can choose from, will, trust, real estate property, personal property, life insurance, retirement fund or an endowment fund. Most important as with any fiancial planning, it's wise to consult with professionals you trust.

In the meantime, we would be happy to answer any questions you may have.

If you have multiple pets, please complete one form for each pet.
We are a Non-Profit 501(c)(3) No-Kill Animal Rescue Organization