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Surrender Form
Please email photo to: pictures@campcompanion.org
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Email *
Your answer
Phone Number *
Your answer
Are you surrendering? *
Is the animal *
Is the animal Spayed/Neutered? *
Animal name *
Your answer
Approximate Date of Birth *
MM
/
DD
/
YYYY
Weight *
Your answer
Dog/Puppy: Breed/Mix Cat/Kitten Color? Long/Short hair? Declawed? *
Your answer
Where did you get the animal? *
Your answer
When did you get the animal? *
Your answer
Animal Health: Cats/Eyes,Nose,Ears? Flea Combed? Please explain *
Your answer
Microchipped *
If yes, please add Microchip number:
Your answer
Why are you surrendering the animal? *
Your answer
*** We will require any surrender to have all vet work provided to us, if you do not have a copy, we will need to know the name and phone number to the Veterinarian the animal was last seen by, You will also need to contact your Veterinarian to release all medical records of the animal to Camp Companion ***
Is there any aggression issues? *
If yes, please explain
Your answer
Good with kids? *
Good with dogs? *
Good with cats? *
Housetrained? *
Activity level? *
Your answer
Kennel trained? *
Good qualities? *
Your answer
Other qualities?
Your answer
Anything else you would like us to know about the animal?
Your answer
Remember to please email photo of the animal you are surrendering to
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