Other Animal Owner Surrender Appointment Request
Your Name
*
First Name
Last Name
Address
*
City
*
State
*
Zip
*
Phone Number
*
Format: (000) 000-0000.
Email
*
Please upload a copy of your ID
*
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SIGNATURE
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DATE
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Month
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Day
Year
Date
Back
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Please tell us about your pet:
Pet Name
*
Type of animal
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How did you obtain this animal?
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Adopted from The Animal Foundation
Adopted from other shelter or rescue organization
Bred at home
Found a lost animal
Gift from family member or friend
Purchased from Pet Store
Purchased from Breeder
Purchased from Social Media / Other
Rehomed by Previous Owner
Other
Please provide detailed information on how you obtained this animal:
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Reason for surrender, please check all that apply:
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Behavior - Animal Aggression
Behavior - Human Aggression
Behavior - Bites
Behavior - Scratches
Behavior - Fearful
Behavior - Potty Training / Litter Box
Behavior - Other
Cost of Care - Medical
Cost of Care - Food / Supplies
Eviction
Landlord
Moving
Owner Health
Please provide detailed on information on why you need to surrender your pet:
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Breed
Color
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Age
*
Please check all that apply to your animal:
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Male
Female
Altered
Sick
Injured
Aged
Aggressive (People)
Aggressive (Animal)
None
What type of food do you feed?
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Times per day fed?
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1-2
3-5
Free Fed
Was your pet around any other animals?
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Yes
No
If yes, yes what type of animals?
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Dogs
Cats
Rabbits
Hamsters
Chinchillas
Rats
Ferrets
Birds
Chickens/Roosters
Turtles
Snakes
Lizards
Other
How long does your pet sleep daily?
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Where was the pet kept?
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Cage
Corral
Free Roam
Other
Did your pets have toys?
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Yes
No
If yes, what types of toys?
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Does your pet allow handling?
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Yes
No
Tolerates it
(Tolerates it) Please explain:
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Does the pet use a litter box (or similar)?
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Yes
No
If yes, type of litter used:
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Clumping
Clay
Wood Pulp
Pellets
Newspaper
Paper
Citrus
Are there any special habits or traits that you would like the new family to know?
*
Does your pet have a regular veterinarian hospital?
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Yes
No
If yes, name of veterinarian:
*
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