Request a Refund – Form If you have adopted and returned an animal within the designated sleepover period and would like a refund of your adoption fee, please submit this form. Adoption InformationToday's Date* Date Format: MM slash DD slash YYYY Name(s)*Address* Street Address Address Line 2 City State ZIP Code Home PhoneCell Phone*Email* Pet's Name*Second Chance Number*Species*DogCatDate of adoption* Date Format: MM slash DD slash YYYY Date of return* Date Format: MM slash DD slash YYYY Method of PaymentCashCheckCredit/Debit CardIf you select check, please list your check number in the Notes field. If you select credit/debit, please list the last four digits of the card in the Notes field.Would you like to donate a portion of your adoption fee towards helping save animals? Yes No If yes, how much?Payment NotesFee Amount Paid