Other Surrender

If you have multiple animals you can submit one form. Just make sure to include all of their names and their information in the boxes below. The following is comprehensive. Please take the time to fill out as much as possible and in detail.

Other animal surrender

* Indicates required field

Name *

First

Last

Email (enter this very carefully!) *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

What is the animal's name? *

What type of animal is this? *

What is the sex of the animal? *

How old is the animal? Approximate is OK. A birthday is even better! *

Is the animal fixed? *

When do you need to surrender this animal? *

Why are you surrending this animal? *

How long have you had this animal? *

Where did you get this animal? *

If you were not the original owner, do you know any history for this animal? *

Is this animal up to date on vaccines? *

Does this animal have any current medical conditions? If so, is it on any medication? *

Please list any veterinarians who have treated this animal and where the vet is located. Write "None" if the animal has never been seen by a vet while in your care. *

Is the animal on any special diet? If so, why? *

Has this animal ever bitten a person or another animal? If yes, please describe what led to the event. *

Please describe this animal's personality. Is it good with women, men, children or other animals? Does it like playtime? Does it have any behavioral issues? Anything you can let us know about the dog allows us to handle it and adopt it out easier. *

Submit