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Dog Surrender Request
* If you have more than one dog, please fill out ONE form for all of your dogs *
Please allow 48-72 hours for a response
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* Indicates required question
Name
*
Your answer
Phone Number
*
Your answer
Email Address
*
Your answer
Which Town do you live in?
*
Your answer
Information about your dog(s)
Please give as much detail as possible
Dog(s) Name(s)
*
Your answer
Where did you originally get your dog(s) from?
*
Your answer
Dog's Age or Birthday
*
Your answer
Color or Markings of your dog(s)
*
Your answer
Breed of your dog(s)
*
Your answer
How long have you owned your dog(s)
*
Your answer
Why do you need to surrender your dog(s)
*
Your answer
Please explain all of your dog(s) known medical issues in as much detail as possible.
*
Your answer
Explain your dog(s) reactions and experiences with other cats and dogs
*
Your answer
Explain your dog(s) reaction to people other than family
*
Your answer
Explain your dog(s) reaction to children and give approximate ages
*
Your answer
Has your dog ever bitten anyone? If yes, please explain.
*
Your answer
What if any training and commands does your dog know?
*
Your answer
Describe your dog(s) behavior when eating its food.
*
Your answer
Describe your dog(s) behavior when given a toy or a bone
*
Your answer
Is your dog spayed or neutered and up to date on vaccinations?
*
Spayed/Neutered
Vaccinated
Neither
Other:
Required
Please add any additional information you'd like us to know about your dog(s)
Your answer
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