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Online Dog Surrender Form

  1. Have you tried looking into help for the reason of surrender?*
  2. Please fill out the following in as much detail as possible. Accurate and detailed information can help us make the best match possible between your pet and family or rescue group.
  3. Pet's gender:*
  4. Is your pet fixed (sterilized/ altered)?*
  5. Where did you get your pet?*

  6. Where does your pet stay the majority of it's time?*
  7. Is your yard fenced?*
  8. Where does the pet sleep?*
  9. What age group has the pet lived with? Select all that apply.*
  10. How would you describe your pet around children? Check all that apply.*
  11. How does your pet react to strangers? Check all that apply.*
  12. Does your pet have any fears? Check all that apply.*
  13. Does your pet have any negative behaviors? Check all that apply.*
  14. Does your pet have any positive behaviors? Check all that apply.*
  15. Does your pet know these basic commands? *
  16. Do you supervise when pet is outside during that time?*
  17. Does your pet escape?*
  18. Has your dog repeatedly escape from the yard?*
  19. If so, how? Check all that apply.*
  20. Has your pet been with other animals? *
  21. Does the dog get along with other animals such as? Check all that apply.*
  22. Has your pet shown any signs of aggression? Check all that apply.*
  23. For any negative or aggressive behavior have you attempted training or had the dog examined?
  24. Does your pet enjoy being groomed?*
  25. Does your pet tolerate having his/her nails clipped? *
  26. Health Info
  27. Has your pet had flea prevention medication within the past 30 days?*
  28. Has your pet had heartworm prevention within the past 30 days?*
  29. When was the dog usually fed?*
  30. Do you own any other animals? Check all that apply.*
  31. Leave This Blank: