Forms, Protocols, and Standard Operating Procedures

LSU School of Veterinary Medicine Emergency Animal Shelter at the LSU AgCenter’s Parker Coliseum

The documents listed in this section were created at the LSU-EAS.  Some documents have been modified to make them more general; others remain specific to the LSU-EAS but may serve as useful guidelines.  These documents may be copied and altered as needed for other emergency situations.

Animal Shelter Admission Form

OWNER INFORMATION                                          DATE:

Owner’s Name _____________________________

Address __________________________ City____________ State____ Zip________

Home Phone (____)_______________ Work Phone (____)_____________________

Cell Phone     (____)_______________ Pager           (____)_____________________         

E-mail Address ___________________ Place of Employment ___________________

Driver’s License # _________________ Social Security # ______________________

How can you be contacted while your pets are here? ____________________________________________________________________

Where you will be staying while away from your home address?

Relation ___________________________________________

Address __________________________ City____________ State____ Zip________

Home Phone (____)_______________ Work Phone (____)_____________________

Cell Phone     (____)_______________ Pager           (____)_____________________ 

How long will your pets be staying in the shelter? _____________________________

Current Veterinarian ____________________________ Phone       _________________

Veterinary Clinic _______________________________

Address _____________________________________________________________

PET INFORMATION

MEDICAL TREATMENT RELEASE

If your pet(s) become(s) ill, we will provide emergency triage veterinary care regarding your pet’s symptoms, treatment options and estimate of costs. If the emergency proves serious enough to require transport to a veterinary hospital,  however, please indicate your wishes should your pet(s) require further treatment to relieve immediate discomfort or to resolve an important medical condition:

____    Please perform whatever services the doctor deems necessary for the best care of my pet until someone can be reached – this includes only non-elective treatments and necessary diagnostics.

____    I authorize up to $______                   ____  I am unable to provide monetary support.

____    Do not administer any medical treatment until specific authorization is given unless the shelter is unable to reach me in a timely fashion. In such a case, I do hereby grant and authorize the shelter to treat or manage my animal(s) as judged appropriate by medical staff, as dictated by medical necessity.

THIS SHELTER IS CLOSING ON SEPTEMBER 30.  I understand that by Sept. 30^th, 2005 I must pick up my pets(s) or notify the shelter that I want to foster or adopt out my pet(s).

I have read and understand this agreement and certify that I am the owner/agent of the above listed animal(s). 

_______________________                                                                          _____________

Sign here owner/agent for pet(s)                                                                                Date

Animal Admission SOP for Vaccines, Physical Exam, and Microchipping

After completion of paperwork at the front desk:

1. Bring the animal to the arena chipping station

2. A veterinarian completes a physical examination

3. The animal will be checked for a chip

4. Give the animal all vaccinations:

   • Dogs: Distemper etc., Rabies, Bordatella

   • Cats: FeVRCP, Rabies

5. Provide endoparasite and ectoparasite control

6. Complete the rabies vaccination certificate

7. Place the rabies tag and certificate in the record

8. Chip any animals that have not yet been chipped.  If the animal is chipped, record the chip information.  Microchip stickers should be distributed as below:

   • 1 goes on the data entry sheet

   • 1 is put on the impound ticket as a record that goes with the animal.   [If the animal is already chipped, write the chip number on the impound ticket]

   • 2 are cut out and placed inside the “Home Again” envelope to go with the animal.

9. Fill out the form

10. Make sure all paperwork is in the animal’s packet:

    • Animal’s information

    • Care sheet

    • Microchip information

    • Rabies vaccination information and tag

Rescued Pet Admission Form  

RESCUER INFORMATION

Rescuer’s Name         _____________________________

Address __________________________ City____________ State____ Zip________

Home Phone (____)_______________ Work Phone (____)_____________________

Cell Phone     (____)_______________ Pager           (____)_____________________ 

Where was the animal found? ____________________________________________

Nearest street intersection ___________________________ City ________________

Was any food, water or medication offered to the animal?

yes/no _______ what kind? _______________________

PET INFORMATION

Assumption of Risk

We want to welcome you, and thank you.  However, we must be clear that this is a disaster relief operation, and certain dangers exist that you should be aware of before assisting with this operation. 

Risks of entering this facility include being bitten by an animal, scratched by an animal, falling, and other obvious and not so obvious dangers.  Many animals have been traumatized, some are sick, all are unpredictable, and may either bite or injure you or cause you to fall or hurt yourself.  Please be careful with dehydration, overheating, lifting heavy objects, and unauthorized personnel.

 By entering these premises, and or by signing up as a volunteer, owner, veterinarian or other, you are therefore agreeing to voluntarily assume all risks of injury and or death, and waive any and all claims that you may have of any kind whatsoever against the owner of the animal who caused such harm, LSU, LSU AgCenter’s Parker Coliseum, LSU Veterinary School, Walter Ernst Foundation, or any other entity, organization or individual who is assisting with the disaster relief operation here at the LSU AgCenter’s Parker Coliseum. 

Please understand that if you are injured for any reason while assisting with this operation, that you shall be solely responsible for your own injuries, medical expenses or any other losses of any kind whatsoever.  If you do not have your own health insurance, you are not allowed to participate in this operation.

If you are not willing to agree to the full assumption of risk for any and all injuries, please do not enter this facility, or participate in any way in disaster relief operations associated with this facility.

WARNING ! Please be extremely careful and be on guard against all dangers ! !

I understand that my participation is strictly voluntary and I freely chose to participate.

Please print and sign your name on the signature line.

_______________________________________________                   __________________

Signature                                                                                                         Date

_______________________________________________                    __________________

Witness                                                                                                           Date

Owner Log In