Surrender Form
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Animal Name *
If surrendering a litter of animals, please include how many:
Species: *
Sex: *
Spayed/Neutered *
Breed
Color
Pattern
Current Age or Approx Date of Birth *
Previous Vet Clinic *
By signing this contract I hereby attest to the following:

As owner, or as a custodian in good faith, I give the animal described above irrevocably to Foxy Family Rescue for whatever disposition Foxy Family Rescue deems best.

I understand that Foxy Family Rescue does not promise to find a home for this animal.

I understand that Foxy Family Rescue will provide all reasonable measures to ensure that the animal(s) have the best chance to be adopted.

Foxy Family Rescue does not guarantee placement of all animals and will make disposition decisions based on the overall health and temperament of the animal(s).

This may include adoption, placement with a rescue, or if Foxy Family Rescue feels the animal is suffering with no good prognosis for recovery or is a danger to the community, they may choose to euthanize.

I give permission for Foxy Family Rescue to contact my previous veterinarian regarding the medical history of the animal.
Has anyone been bitten or scratched by this animal in the past 14 days? *
Specific circumstances of bite or scratch:
e-Signature *
Phone Number: *
Email Address: *
Address Line 1: *
Address Line 2:
City: *
State: *
Zip Code: *
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