Owner Surrender Questionnaire
Complete this form for surrender of a Dog to Pickens County Animal Shelter
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Your Name *
Phone Number *
Email *
Dog's Name *
Breed *
Sex of Dog *
Spayed or Neutered *
Age *
Why are you surrendering your pet? *
Where did you get your pet? *
Current on Vaccines? *
Name of vet?  Please bring any medical records you may have with you. *
Does this pet have any medical conditions or previous injuries? *
If yes to the last question, please explain
Has this pet ever bitten a person or another animal? *
If yes to the last question, please explain
Where does your dog spend most of it's time? *
Where does your dog sleep? *
Is your dog housebroken? *
Is your dog crate trained? *
What type of food does this pet eat? *
Has your dog ever been around other dogs? *
Does your dog play well with other dogs? *
Has your dog ever lived in a home with children? *
Is your dog fearful of any of the following? *
Does this pet have any behavior issues or destructive tendencies? *
If yes to the last question, please explain
Have you tried to rehome your pet? *
How long have you been trying
Any other ADDITIONAL NOTES that you would like to share with the staff about your pet?
Do you understand that when you surrender your pet to Pickens County Animal Shelter you will no longer have any rights to this pet and no further information regarding this pet will be given? *
Do you understand that every effort will be made to place the animal(s).  However, due to poor health, injuries beyond repair, and bad or unpredictable temperament, euthanasia is always a possibility. *
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