Paw's Place

A No-kill, Non-Profit Animal Rescue, Rehabilitation and Retirement Facility
3701 Boiling Spring Road, Winnabow, NC 28479
(910) 845-PAWS

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Emergency Information Form

Welcome to Paw's Place Adoption Program. Thank you for volunteering your time and effort to our organization. We need this information in case of an emergency that requires us to contact someone on your behalf. Please fill out completely and give to a Paw's Place representative, or mail this form to Paw's Place, Inc., 3701 Boiling Spring Road, Winnabow, NC 28479 or fax to (910) 845-8622.

PLEASE PRINT:

In case of an emergency, the following person is to be contacted immediately:

Full Name:_________________________________________

Relationship to volunteer:________________________________

Phone # home________________________________________

Phone # work________________________________________

Cell phone #______________________________________

 

In case an ambulance needs to be called:

my health insurance card can be found _______________________________________

a medical alert card can be found _______________________________________

 

Thank You!

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