Dog Surrender Application

All surrenders will be subject to a surrender fee and can be up to $500 per dog depending on circumstances. This will be determined by the board. 

Please be aware that we’re a network of foster homes and volunteers without a shelter building, and with limited resources. As a result we might not be able to take your animal into our care. 

Sign in to Google to save your progress. Learn more
Animal Details
Name *
Age *
Breed *
Gender *
If female, has she had a litter before? When and how many? What happened to pups?
Weight *
Spayed or Neutered *
Microchipped or Tattoeed *

Where did you get your dog from, and when?

 *

Why did you not get your dog from a rescue?

 *
Owner Details
Name *
Phone Number *
Address *
City
Email Address (We will be contacting you by this address)
 *
Are you the owner? *
Reason for surrender? *
Do you have vaccination records? *
When was the last vet appointment? *
MM
/
DD
/
YYYY
List of all medical problems (if any)
Food allergies (if any)
Does your dog bark, whine or howl when left alone?
How is your dog around other animals mainly dogs and cats? 
 *
How is your dog around children?
 *
Has your dog ever bitten or attempted to bite a person? 
 *
Has your dog ever bitten or attempted to bite another dog?
 *
Does your dog have any fears? (ie. thunder, car rides, people in hats)
 *
How does your dog react to strangers? ( ie. barks, hides, happy) 
 *
Describe dogs nature? (ie. friendly, shy, playful, challenging)
 *
Areas of problems for your dog? (Check all that apply)
 *
Required
Any other pertinent information?
Submit
Clear form
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms