Wags & Kisses Owner Surrender Form
Dogs Name *
Your answer
Breed *
Your answer
Age/Approximate Birth Date *
MM
/
DD
/
YYYY
Male/Female *
Is the dog spayed/neutered? *
Approximate weight *
Your answer
Up to Date on Shots? Please check all that apply *
Required
How long have you owned this animal? *
Your answer
If dog isn't up to date on shots are you willing to get them done before surrendering the dog to the rescue? *
Required
Where did you get this animal? *
Is the animal friendly with(please check that all apply) *
Required
Is Dog on Heartworm Preventative? *
Is Dog House trained? *
Is Dog Crate/Kennel Trained? *
Does the dog require a fence? *
Microchipped? *
Are you aware of any medical or behavioral problems that this dog has? *
Your answer
Vet Name and Phone Number? *
Your answer
Do you give a representative with Wags and Kisses Rescue permission to contact your vet office to obtain any necessary information about the dog being surrendered? If yes, please initial. *
Your answer
What brand of food do you feed the dog being surrendered? *
Your answer
Owner Name *
Your answer
Address include city and state *
Your answer
Email Address *
Your answer
Phone Number with area code *
Your answer
Any other information we would need to know about the dog being surrendered
Your answer
We ask that a $50 surrender fee is paid before surrendering your dog to cover any vetting or any other costs that we may have. This will be done via our Paypal through the rescue. If this is a problem please state the reason otherwise let us know what email to send payment to. *
Your answer
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