Surrender Application
Please provide as much information as you can. Please give all the positive information and all the negative things as that will allow us to help them the best! It's best if you can describe personalities too if you know, the more personal and in-depth, the better. We want to set the dog up for success in foster or in our director's home/training to be sure we are keeping everyone safe!
First Name
Last Name
Email
Phone Number
Address
What animal do you need to surrender?
Select an option
Kitten
Cat
Puppy (
Dog (Adult)
Senior Dog (>7 years)
Is this a litter of kittens or puppies? *If so, provide details at bottom of form
Select an option
Yes
No
Name of Animal
Age of Animal
Sex of Animal
Select an option
Male
Female
Breed
Color
How did you acquire this animal?
Do you have medical records?
Select an option
Yes
No
Upload Medical Records
Select a File
Are they:
Spayed or Neutered?
Microchipped?
Up to date on Rabies Vaccine?
Had any other Vaccines?
Dewormer given?
Current on Heartworm test?
On Heartworm Prevention?
Are they on Flea/Tick/Parasite Prevention?
Have their teeth been cleaned?
Date last Rabies Vaccine given:
Any known illnesses or other medical concerns?
Are they:
Good with other Dogs?
Only Female Dogs
Only Male Dogs
Good with Small Dogs?
Good with Cats?
Good with Kids 0-5 years?
Good with Kids 6-10 years?
Good with Teen or Older?
Crate Trained?
Potty Trained?
Shown any Food Aggression towards humans?
Shown any Resource Guarding (food/toys/people)*?
Bite or Snap History?
Comfortable meeting Strangers?
Comfortable with Strangers in the Home?
Reactive to other Dogs on a Leash?
Have they ever been to a Dog Park?
Any behavior Concerns?**
Any Special Needs?***
*If yes on Resource Guarding, please explain
**If yes on Behavior Concerns, please explain
***If yes on Special Needs, please explain
How are they in public places?
What training do they know?
Sit
Down
Wait
Leash Skills
Place
Stay
They have not had any training
What can you tell me about them? Please describe in detail your dog's temperament, please give all the positive information and all the negative things as that will allow us to help them the best!
If a litter, please list details of breed, age and number of males and females
Have they been:
Microchipped?
Dewormed?
Rabies Vaccine given?
Any other vaccines given?
For litters: Please provide any additional information on medical history:
For litters: Do you have medical records?
Select an option
Yes
No
For litters: Upload medical records
Select a File
For all surrenders: Please provide photos
Select a File
Please provide any additional information that you feel will be helpful for our team:
What is your timeframe for surrendering?
How did you hear about us?
Submit
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