Chinchilla Placement Assistance Request

Surrendering Owner Information

Your Name (*)
Please enter your name
E-mail Address (*)
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Phone Number
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City (*)
Please enter your city of residence
State (*)
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What is the number of animals you want to surrender? (*)
Please select the number of animals you want to surrender
Where did you originally get your animal(s)? (*)
Please indicate where you originally got your animal(s)
What is the name and city of the rescue/shelter where you adopted your pet(s)? (*)
Please indicate the name and city of the shelter or rescue where you originally adopted your pet(s)
What is the name of the pet store and the city where you purchased this animal/these animals? (*)
Please enter the name and city of the pet store where you purchased your pet(s)
How long have you owned the animal(s)? (*)
Please indicate how long you have owned your animal(s)
What is the reason you want to surrender your pet(s)? (*)
Please describe why you need to give up your pet(s)
How long can the animal(s) currently remain under your care? (*)
Please indicate how soon you need to give up your animal(s)
Are you interested in Placement Assistance Services? (*)
Please indicate if you wish to participate in our Placement Assistance program
Are you interested in surrendering your animal(s) to North Star Rescue? (*)
Please indicate if you wish to surrender this animal to our rescue.
The Placement Assistance Program is for owners who can keep their animal(s) under their care and meet with potential adopters until a new home is found. North Star Rescue provides advice on screening potential homes, provides online listings for your pet(s), and referrals of adopters who contact us in your area that may be a good potential match.

You may request to participate in the Placement Assistance program even if you can only keep your pet(s) for a limited amount of time.

Placement Assistance Information

How do you want potential adopters to contact you? (*)
Please select a method of contact
What is the adoption fee you are asking for your pet(s)? (*)
Please enter an adoption fee. We do not recommend giving away pets or listing "free to a good home"
We recommend that you charge an adoption fee for your small animal. Animals who are given away "Free to a good home" may be sought out by individuals looking for a bait/food animal or for another unfavorable purpose. If you do not feel comfortable taking money for your animal(s), we suggest that you request the adopters donate a fee to your local animal shelter or rescue organization.
If you are including a cage, accessories or other pet equipment with your pet, please describe it here
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Pet Chinchilla Profile

Chinchilla #1 Information

Chinchilla #1 - Name
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Chinchilla #1 - Age Range (*)
Please select an age range for your pet. If you do not know your pet's age, please select 'Unknown'
Chinchilla #1 - Gender (*)
Please select a gender. If you do not know the gender of your pet, please select 'Unknown'
Chinchilla #1 - Primary Color (*)
Please select your pet's primary color
Chinchilla #1 - Secondary Color
Please select a primary color for Rat #1
Chinchilla #1 - Eye Color
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Chinchilla #1 - Has this chinchilla lived with other chinchillas before? (*)
Please indicate if your pet has lived with others of the same species before
Chinchilla #1 - Has this chinchilla ever bitten a human to your knowledge? (*)
Please indicate if this pet has bitten a human before
Chinchilla #1 - Describe the circumstances where the bite occurred (*)
Please provide information about when the pet has bitten humans
Chinchilla #1 - How does this chinchilla react to being handled by humans? (*)
Please enter a description of how your pet behaves or reacts when being handled by humans
Chinchilla #1 - Has this chinchilla ever interacted with children? (*)
Please indicate if this pet has ever interacted with children
Chinchilla #1 - How does this chinchilla react to being handled by children? (*)
Please describe how this pet reacts to being handled by children
Chinchilla #1 - Describe your pet's personality/behavior
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Chinchilla #1 - Does this chinchilla have any of the following special requirements for their new home? (Check all that apply)





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Chinchilla #1 - Upload a Picture
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Chinchilla #2 Information

Chinchilla #2 - Name
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Chinchilla #2 - Age Range (*)
Please select an age range for your pet. If you do not know your pet's age, please select 'Unknown'
Chinchilla #2 - Gender (*)
Please select a gender. If you do not know the gender of your pet, please select 'Unknown'
Chinchilla #2 - Primary Color (*)
Please select your pet's primary color
Chinchilla #2 - Secondary Color
Please select a primary color for Rat #1
Chinchilla #2 - Eye Color
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Chinchilla #2 - Has this chinchilla lived with other chinchillas before? (*)
Please indicate if your pet has lived with others of the same species before
Chinchilla #2 - Has this chinchilla ever bitten a human to your knowledge? (*)
Please indicate if this pet has bitten a human before
Chinchilla #2 - Describe the circumstances where the bite occurred (*)
Please provide information about when the pet has bitten humans
Chinchilla #2 - How does this chinchilla react to being handled by humans? (*)
Please enter a description of how your pet behaves or reacts when being handled by humans
Chinchilla #2 - Has this chinchilla ever interacted with children? (*)
Please indicate if this pet has ever interacted with children
Chinchilla #2 - How does this chinchilla react to being handled by children? (*)
Please describe how this pet reacts to being handled by children
Chinchilla #2 - Describe your pet's personality/behavior
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Chinchilla #2 - Does this chinchilla have any of the following special requirements for their new home? (Check all that apply)





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Chinchilla #2 - Upload a Picture
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Chinchilla #3 Information

Chinchilla #3 - Name
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Chinchilla #3 - Age Range (*)
Please select an age range for your pet. If you do not know your pet's age, please select 'Unknown'
Chinchilla #3 - Gender (*)
Please select a gender. If you do not know the gender of your pet, please select 'Unknown'
Chinchilla #3 - Primary Color (*)
Please select your pet's primary color
Chinchilla #3 - Secondary Color
Please select a primary color for Rat #1
Chinchilla #3 - Eye Color
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Chinchilla #3 - Has this chinchilla lived with other chinchillas before? (*)
Please indicate if your pet has lived with others of the same species before
Chinchilla #3 - Has this chinchilla ever bitten a human to your knowledge? (*)
Please indicate if this pet has bitten a human before
Chinchilla #3 - Describe the circumstances where the bite occurred (*)
Please provide information about when the pet has bitten humans
Chinchilla #3 - How does this chinchilla react to being handled by humans? (*)
Please enter a description of how your pet behaves or reacts when being handled by humans
Chinchilla #3 - Has this chinchilla ever interacted with children? (*)
Please indicate if this pet has ever interacted with children
Chinchilla #3 - How does this chinchilla react to being handled by children? (*)
Please describe how this pet reacts to being handled by children
Chinchilla #3 - Describe your pet's personality/behavior
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Chinchilla #3 - Does this chinchilla have any of the following special requirements for their new home? (Check all that apply)





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Chinchilla #3 - Upload a Picture
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Chinchilla #4 Information

Chinchilla #4 - Name
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Chinchilla #4 - Age Range (*)
Please select an age range for your pet. If you do not know your pet's age, please select 'Unknown'
Chinchilla #4 - Gender (*)
Please select a gender. If you do not know the gender of your pet, please select 'Unknown'
Chinchilla #4 - Primary Color (*)
Please select your pet's primary color
Chinchilla #4 - Secondary Color
Please select a primary color for Rat #1
Chinchilla #4 - Eye Color
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Chinchilla #4 - Has this chinchilla lived socially with other chinchillas before? (*)
Please indicate if these rats have lived with others before
Chinchilla #4 - Has this chinchilla ever bitten a human to your knowledge? (*)
Please indicate if this pet has bitten a human before
Chinchilla #4 - Describe the circumstances where the bite occurred (*)
Please provide information about when the pet has bitten humans
Chinchilla #4 - How does this chinchilla react to being handled by humans? (*)
Please enter a description of how your pet behaves or reacts when being handled by humans
Chinchilla #4 - Has this chinchilla ever interacted with children? (*)
Please indicate if this pet has ever interacted with children
Chinchilla #4 - How does this chinchilla react to being handled by children? (*)
Please describe how this pet reacts to being handled by children
Chinchilla #4 - Describe your pet's personality/behavior
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Chinchila #4 - Does this chinchilla have any of the following special requirements for their new home? (Check all that apply)





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Chinchilla #4 - Upload a Picture
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Chinchilla Group Information

Chinchilla's Names
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Chinchilla Age(s) (*)




Please select at least one age group, or check 'unknown' if you do not know
Chinchilla Genders (check all that apply) (*)




Please select a gender. If you do not know the gender of your pet, please select 'Unknown'
Provide a description of the chinchillas (Such as color/markings and eye color) (*)
Please describe your pet's physical appearance or markings.
Have these chinchillas lived socially with other chinchillas before? (*)
Please indicate the type of social situation your pets live in
Have any of these chinchillas ever bitten a human? (*)
Please indicate if any of these pets have bitten a human before
Describe the circumstances where the bite occurred (*)
Please provide information about when the pet has bitten humans
How do these chinchillas react to being handled by humans? (*)
Please enter a description of how your pets behave or react when being handled by humans
Have any of these chinchillas ever interacted with children? (*)
Please indicate if these pets have ever interacted with children
How do the chinchillas react to being handled by children? (*)
Please describe how these pets react to being handled by children
Describe your pet's personality/behavior
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Do your chinchillas have any of the following special requirements for their new home? (Check all that apply)





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Upload a Picture (#1)
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Upload a Picture (#2)
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Upload a Picture (#3)
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Medical History

Have you taken any of these pet(s) to a veterinarian? (*)
Please indicate if you have ever taken your pet(s) to a vet.
Please provide details on the reason for your pet's vet visits
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Have your chinchillas(s) been exposed to chinchillas from another household, pet store or other location in the last 30 days? (*)
Please indicate if your rat has visited with or been exposed to rats from another location in the last 30 days.
Do any of the animals on your application have any of the following symptoms of respiratory illness? (Check all that apply)




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Have any of the female chinchillas on your application been exposed to an unneutered male chinchilla within the last 75 days? (*)
If you do not know if your female rat has been in contact with a male rat, please select "I don't know"
Do any of the animals on your application have other medical issues? If so, please describe.
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