Animal Surrender Form
Email address *
Your Name *
Your answer
Phone Number *
Your answer
Address *
Your answer
City *
Your answer
Province *
Your answer
Postal Code *
Your answer
Animal Name *
Your answer
Location Lived/Found/Rescued *
Your answer
Species *
Your answer
Breed *
Your answer
Gender *
Age *
Your answer
Fixed *
Identifying Marks/Colours *
Your answer
Does your animal or has your animal had any medical conditions or does your animal take any medications regularly? *
Your answer
Does your animal have any type of behaviour issues? Including aggression, food aggression, etc *
Your answer
How is your animal with men? *
Your answer
How is your animal with women? *
Your answer
How is your animal with children? *
Your answer
How is your animal with dogs? *
Your answer
How is your animal with cats? *
Your answer
Is your animal leash trained? *
Is your animal kennel trained? *
Has anyone in your household, or your animal traveled to British Columbia or Ohio within the past month? *
Reason for surrender *
Your answer
Vet records can be found at *
Your answer
Additional Information *
Your answer
A copy of your responses will be emailed to the address you provided.
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