Surrender Profile Form

Contact Information

Basic Dog Information

i.e. - My dog has seasonal allergies and needs an antihistamine in the summer, my dog is diabetic and needs insulin injections, my dog has glaucoma, etc.
We will be contacting your vet for copies of your dogs medical records. They may contact you to get permission to release them to us.

Reason for Surrender

PLEASE NOTE: It's important for you to be honest and forthcoming about your dog’s history, health, and behavior, no matter how bad. The more we know, the better equipped we are to find the best possible home for your dog. **If your reason for surrender is a pending move, please include your move date**

Home Environment

i.e. - in their crate, loose in the house, outside, etc.
i.e. - in their crate, loose in the house, outside, etc.

Social Skills

Choose all that apply
i.e.-bared teeth, growled, lunged, snapped, or bitten a person

Training and Behavior

House trained means only goes potty outside, not on pee pads, or fake grass, etc.
Choose all that apply
Choose all that apply
Anything else you think we should know about your dog? Questions about the surrender process?